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EÏÏËÓÈÎ‹ NÔÛÔÎÔÌÂÈ·Î‹ O‰ÔÓÙÈ·ÙÚÈÎ‹

EÏÏËÓÈÎ‹ NÔÛÔÎÔÌÂÈ·Î‹ O‰ÔÓÙÈ·ÙÚÈÎ‹ ñ TfiÌÔ˜ 4 ñ 2011

EÙ‹ÛÈ· ŒÎ‰ÔÛË ÙË˜

EÏÏËÓÈÎ‹˜ EÙ·ÈÚÂ›·˜ NÔÛÔÎÔÌÂÈ·Î‹˜ O‰ÔÓÙÈ·ÙÚÈÎ‹˜

ISSN 1791-9130

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TOMO™ 4, 2011ISSN 1791-9130

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¶EPIEXOMENA

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ÂÂÓÓËËÏÏ››ÎÎˆ̂ÓÓ ··ÛÛııÂÂÓÓÒÒÓÓ..

A. KÔÎÎÔÚ¤, A. ¢ÔÓÙ¿, K. NÈÎÔÔ‡ÏÔ˘-K·Ú·ÁÈ¿ÓÓË ....................11-17

ñ HH ÂÂÈÈÎÎÔÔÈÈÓÓˆ̂ÓÓ››·· ÌÌÂÂ ÙÙÔÔÓÓ ··ÛÛııÂÂÓÓ‹‹ ÎÎ··ÙÙ¿¿ ÙÙËËÓÓ ÎÎÏÏÈÈÓÓÈÈÎÎ‹‹ ÔÔ‰‰ÔÔÓÓÙÙÈÈ··ÙÙÚÚÈÈÎÎ‹‹ ÚÚ¿¿ÍÍËË..

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H. X. K·ÚÎ·˙‹˜ ..........................................................................19-22

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B. P‹Á·, A. E. KÔÛÈÒÓË ...............................................................23-28

ñ BBÂÂÏÏÙÙÈÈÒÒÓÓÔÔÓÓÙÙ··˜̃ ÙÙËË ™™¯̄¤¤ÛÛËË OO‰‰ÔÔÓÓÙÙÈÈ¿¿ÙÙÚÚÔÔ˘̆--AAÛÛııÂÂÓÓ‹‹.. MMÂÂ ¤¤ÌÌÊÊ··ÛÛËË ÛÛÙÙÔÔÓÓ EEÈÈ‰‰ÈÈÎÎfifi

AAÛÛııÂÂÓÓ‹‹..

E. MÔÁÔÛÈ¿Ó ..............................................................................29-34

ñ XXÚÚfifiÓÓÈÈ·· ÓÓÂÂÊÊÚÚÈÈÎÎ‹‹ ÓÓfifiÛÛÔÔ˜̃ ÎÎ··ÈÈ ÛÛÙÙÔÔÌÌ··ÙÙÈÈÎÎ‹‹ ˘̆ÁÁÂÂ››··

AÈÎ. ¢ËÌËÙÚ›Ô˘, º. ZÂÚ‚Ô‡-B¿Ï‚Ë ...............................................35-43

ñ ™™ÙÙÔÔÌÌ··ÙÙÔÔ‰‰˘̆ÓÓ››··

¶. M·Ú·ÁÎÔ‡ ..............................................................................45-50

EÏÏËÓÈÎ‹ NÔÛÔÎÔÌÂÈ·Î‹O‰ÔÓÙÈ·ÙÚÈÎ‹

EÏÏËÓÈÎ‹ EÙ·ÈÚÂ›· NÔÛÔÎÔÌÂÈ·Î‹˜ O‰ÔÓÙÈ·ÙÚÈÎ‹˜

TOMO™ 4, 2011ISSN 1791-9130

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E¢PA EK¢O™H™M·˘ÚÔÁ¤ÓÔ˘˜ 32 X·˚‰¿ÚÈ TK 124 61TËÏ.& Fax: (210) 58.16.778www.hospitaldentistry.gre-mail: [email protected]

ñ BB··ÛÛÈÈÎÎ¿¿ ÛÛÙÙÔÔÈÈ¯̄ÂÂ››·· ÙÙËË˜̃ ÌÌ··ÁÁÓÓËËÙÙÈÈÎÎ‹‹˜̃ ÙÙÔÔÌÌÔÔÁÁÚÚ··ÊÊ››··˜̃.. EEÊÊ··ÚÚÌÌÔÔÁÁ¤¤˜̃ ÛÛÙÙËËÓÓ

OO‰‰ÔÔÓÓÙÙÈÈ··ÙÙÚÚÈÈÎÎ‹‹..

A. ¢ÂÏ·ÓÙÒÓË .............................................................................51-56

ñ MMÂÂÙÙÂÂÌÌÊÊ‡‡ÙÙÂÂ˘̆ÛÛËË ‰‰ÔÔÓÓÙÙÈÈÒÒÓÓ

°. BÂÓ¤ÙË˜, ¶. °. §ÈÔÎ¿ÙË˜, º. K·ÙÛÈÎ¿ÓË˜ .................................57-64

ñ ¶¶··ÚÚÔÔ¯̄‹‹ ÔÔ‰‰ÔÔÓÓÙÙÈÈ··ÙÙÚÚÈÈÎÎ‹‹˜̃ ÊÊÚÚÔÔÓÓÙÙ››‰‰··˜̃ ÛÛÂÂ ¿¿ÙÙÔÔÌÌ·· ÌÌÂÂ ÛÛˆ̂ÌÌ··ÙÙÈÈÎÎ‹‹ ‹‹//ÎÎ··ÈÈ ÓÓÔÔËËÙÙÈÈÎÎ‹‹

‰‰ÈÈ··ÙÙ··ÚÚ··¯̄‹‹..

™. °ÎÈ˙¿ÓË ...................................................................................65-71

ñ 44ÔÔ ¶¶··ÓÓÂÂÏÏÏÏ‹‹ÓÓÈÈÔÔ ™™˘̆ÓÓ¤¤‰‰ÚÚÈÈÔÔ NNÔÔÛÛÔÔÎÎÔÔÌÌÂÂÈÈ··ÎÎ‹‹˜̃ OO‰‰ÔÔÓÓÙÙÈÈ··ÙÙÚÚÈÈÎÎ‹‹˜̃

3300//99--22//1100//22001111,, AAıı‹‹ÓÓ··:: AAÔÔÏÏÔÔÁÁÈÈÛÛÌÌfifi˜̃ ..........................................73-75

HellenicHospitalDentistry

Hellenic Society for Hospital Dentistry

VOLUME 4, 2011ISSN 1791-9130

PROPRIETOR:Hellenic Society for Hospital Dentistry

EDITOR -IN- CHIEF:F. Zervou-Valvi

EDITORIAL BOARD:D. Andresakis A. Antoniadou P. Thanoulis Th. ZouridakiM. Katsourakis I. Koutsoukos E. Bogosian M. Fragakis

SCIENTIFIC CONSULTANTSK. Alexandridis K. AntoniadisG. Vougiouklakis A.DoukoudakisH. Karkazis A. KÔssioniO. Nicolatou L. PapagiannoulisA. Sklavounou J. G. TzoutzasK. Tsiklakis

PRODUCTION SUPERVISORS:F. Zervou-Valvi, M. Fragakis, J. Koutsoukos, J. Fandridis

PRODUCTION - PROMOTION:TypeProductV. & E. Babai Ltd32 Epikourou Str., Athens HellasPhone#: (3210) 32.14.904Fax#: (3210) 32.14.991

The journal Hellenic Hospital Dentistry is theofficial publication of the Hellenic Society forHospital Dentistry It is published annually.Subscription: 10 $ USD

PUBLISHER:Hellenic Society for Hospital Dentistry President: Flora Zervou-Valvi

ADDRESS32 Mavrogenous Str., Haidari, 124 61Phone &Fax#: (3210) 58.16.778www.hospitaldentistry.gre-mail: [email protected]

CONTENTS

ññ DDeennttaall ffeeaarr.. FFrreeqquueennccyy aanndd ccoonnsseeqquueenncceess ffoorr tthhee oorraall hheeaalltthh ooff aadduulltt

ppaattiieennttss..

A. Kokkore, A. Donta, K. Karayianni ............................................11-17

ññ TThhee ddeennttiisstt--ppaattiieenntt rreellaattiioonnsshhiipp iinn tthhee eevveerryyddaayy ddeennttaall pprraaccttiiccee

H. Karkazis .................................................................................19-22

ññ CCoommmmuunniiccaattiioonn bbeettwweeeenn tthhee ddeennttiisstt aanndd tthhee oollddeerr ddeennttaall ppaattiieenntt

V. Riga, A. Kossioni ....................................................................23-28

ññ IImmpprroovviinngg tthhee ddeennttiisstt--ppaattiieenntt rreellaattiioonnsshhiipp.. EEmmpphhaassiizziinngg oonn ssppeecciiaall

nneeeeddss ppaattiieenntt..

E. Bogosian .................................................................................29-34

ññ CChhrroonniicc kkiiddnneeyy ddiisseeaassee aanndd oorraall hheeaalltthh

A. Dimitriou, F. Zervou-Valvi .......................................................35-43

ññ BBuurrnniinngg MMoouutthh SSyynnddrroommee

P. Maragou ..................................................................................45-50

HellenicHospitalDentistry

Hellenic Society for Hospital Dentistry

VOLUME 4, 2011ISSN 1791-9130

PROPRIETOR:Hellenic Society for Hospital Dentistry

EDITOR -IN- CHIEF:F. Zervou-Valvi

EDITORIAL BOARD:D. Andresakis A. Antoniadou P. Thanoulis Th. ZouridakiM. Katsourakis I. Koutsoukos E. Bogosian M. Fragakis

SCIENTIFIC CONSULTANTSK. Alexandridis K. AntoniadisG. Vougiouklakis A.DoukoudakisH. Karkazis A. KÔssioniO. Nicolatou L. PapagiannoulisA. Sklavounou J. G. TzoutzasK. Tsiklakis

PRODUCTION SUPERVISORS:F. Zervou-Valvi, M. Fragakis, J. Koutsoukos, J. Fandridis

PRODUCTION - PROMOTION:TypeProductV. & E. Babai Ltd32 Epikourou Str., Athens HellasPhone#: (3210) 32.14.904Fax#: (3210) 32.14.991

The journal Hellenic Hospital Dentistry is theofficial publication of the Hellenic Society forHospital Dentistry It is published annually.Subscription: 10 $ USD

PUBLISHER:Hellenic Society for Hospital Dentistry President: Flora Zervou-Valvi

ADDRESS32 Mavrogenous Str., Haidari, 124 61Phone &Fax#: (3210) 58.16.778www.hospitaldentistry.gre-mail: [email protected]

ññ BBaassiicc ffeeaattuurreess ooff MMaaggnneettiicc RReessoonnaannccee IImmaaggiinngg ((MMRRII)) aanndd iittss

aapppplliiccaattiioonnss iinn DDeennttiissttrryy

A. Delantoni ...............................................................................51-56

ññ TTooootthh ttrraannssppllaannttaattiioonn

G. Venetis, P.G. Liokatis, F. Katsikanis . .......................................57-64

ññ PPrroovviissiioonn ooff ddeennttaall ttrreeaattmmeenntt ttoo ppaattiieennttss wwiitthh pphhyyssiiccaall oorr mmeennttaall

pprroobblleemm..

S. Gizani ......................................................................................65-71

ññ 44tthh PPaannhheelllleenniicc CCoonnggrreessss ooff HHoossppiittaall DDeennttiissttrryy 3300//99--22//1100//22001111,,

AAtthheennss:: RReeppoorrtt .............................................................................73-75

™HMEIøMA ™YNTA•H™

TÔ 2011 ˘‹ÚÍÂ Ì›· ÛÔ˘‰·›· ¯ÚÔÓÈ¿ ÁÈ· ÙËÓ EÙ·ÈÚÂ›· Ì·˜.

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Ì·˜ Â¤ÙÚÂ„·Ó Ó· ˙ËÙ‹ÛÔ˘ÌÂ ÂÍÂÈ‰ÈÎÂ˘Ì¤ÓË ‚Ô‹ıÂÈ·, Î·Ù·Ê¤Ú·ÌÂ, ÌË ÊÂÈ‰fiÌÂÓÔÈ ÎfiˆÓ ‚¤-

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TÔ ™˘Ó¤‰ÚÈÔ Â›¯Â Ù›ÙÏÔ «H O‰ÔÓÙÈ·ÙÚÈÎ‹ EÈ‰ÈÎ‹˜ ºÚÔÓÙ›‰·˜ ÛÙÔÓ 21Ô AÈÒÓ·», Ú·ÁÌ·ÙÔÔÈ‹-

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ÙÔ˘ ¢‹ÌÔ˘ AıËÓ·›ˆÓ Î·È ÛÙÔ Ï·›ÛÈfi ÙÔ˘ ÙÈÌ‹ıËÎÂ Ô EÏ‚ÂÙfi˜ Ô‰ÔÓÙ›·ÙÚÔ˜ Dr Julien Grivel,

ÁÈ· ÙËÓ ÂıÂÏÔÓÙÈÎ‹ ÔÏ˘ÂÙ‹ ÙÔ˘ ‰Ú¿ÛË ÛÙËÓ ·ÚÔ¯‹ ÓÔÛÔÎÔÌÂÈ·ÎÒÓ Ô‰ÔÓÙÈ·ÙÚÈÎÒÓ ˘ËÚÂ-

ÛÈÒÓ ÛÙÔ˘˜ ŒÏÏËÓÂ˜ ¯·ÓÛÂÓÈÎÔ‡˜. §ÂÙÔÌÂÚ‹˜ ·ÔÏÔÁÈÛÌfi˜ ÙÔ˘ ™˘ÓÂ‰Ú›Ô˘ ·Ú·Ù›ıÂÙ·È

ÛÙÔ ÙÂÏÂ˘Ù·›Ô ÎÂÊ¿Ï·ÈÔ ÙÔ˘ ·ÚfiÓÙÔ˜ ÙfiÌÔ˘.

E›ÛË˜, ÚÔ¯ˆÚ‹Û·ÌÂ ÛÙËÓ ¤Î‰ÔÛË ÙÔ˘ 3Ô˘ ÙfiÌÔ˘, ÛÙÔÓ ÔÔ›Ô ÂÓÛˆÌ·ÙÒÛ·ÌÂ Î·È Ù·

¶Ú·ÎÙÈÎ¿ ÙÔ˘ ™˘ÓÂ‰Ú›Ô˘. O ÙfiÌÔ˜ ·˘Ùfi˜, Î·Ï·›ÛıËÙÔ˜ fiˆ˜ Î·È ÔÈ ÚÔËÁÔ‡ÌÂÓÔÈ, ÌÂ ÏÔ‡-

ÛÈ· ÔÈÔÙÈÎ‹ ‡ÏË, ¤Ù˘¯Â Â˘ÚÂ›·˜ ÂÎ Ó¤Ô˘ ·Ô‰Ô¯‹˜.

TÔ 2012, ‰ËÏÒÓÔ˘ÌÂ ¿ÏÈ ‰˘Ó·ÌÈÎ¿ ·ÚfiÓÙÂ˜, ÌÂ ÙËÓ ¤Î‰ÔÛË ÙÔ˘ 4Ô˘ ÙfiÌÔ˘ ÙË˜ «EÏÏËÓÈÎ‹˜

NÔÛÔÎÔÌÂÈ·Î‹˜ O‰ÔÓÙÈ·ÙÚÈÎ‹˜». H ¤Î‰ÔÛË Â›Ó·È Í·Ó¿ ¤ÓÙ˘Ë, fiÌˆ˜ ÔÈ Û˘˙ËÙ‹ÛÂÈ˜ ÁÈ· ÂÓ‰Â-

¯fiÌÂÓË ËÏÂÎÙÚÔÓÈÎ‹ ¤Î‰ÔÛË ÙÔ˘ ÂÚÈÔ‰ÈÎÔ‡ Ì·˜ ¤¯Ô˘Ó ·Ó¿„ÂÈ ÁÈ· Ù· Î·Ï¿. ÿ‰ˆÌÂÓ...

™ÙÔÓ ·ÚfiÓÙ· ÙfiÌÔ ÂÂÏ¤ÁË ÌÂÁ¿ÏÔ Ì¤ÚÔ˜ Ó· ·ÊÈÂÚˆıÂ› ÛÂ ÂÚÁ·Û›Â˜ Ô˘ ·Ó·Ê¤ÚÔÓÙ·È ÛÙËÓ

„˘¯ÔÛ‡ÓıÂÛË, ÛÙËÓ ÂÈÎÔÈÓˆÓ›· Î·È ÙÈ˜ ‰È·ÚÔÛˆÈÎ¤˜ Û¯¤ÛÂÈ˜ Ô‰ÔÓÙÈ¿ÙÚÔ˘-·ÛıÂÓ‹. TÔ ÂÓ-

‰È·Ê¤ÚÔÓ Ô˘ ÂÂ‰Â›¯ıË ÁÈ· Ù¤ÙÔÈ· ı¤Ì·Ù· Î·Ù¿ ÙË ‰È¿ÚÎÂÈ· ÙÔ˘ ™˘ÓÂ‰Ú›Ô˘, Ù· ÔÔ›· Û·ÊÒ˜

ÂËÚÂ¿˙Ô˘Ó ÙËÓ ·ÚÔ¯‹ ÙË˜ Ô‰ÔÓÙÈ·ÙÚÈÎ‹˜ ÂÚ›ı·Ï„Ë˜ Î·È ÙËÓ Î·Ù¿ÛÙ·ÛË ÙË˜ ÛÙÔÌ·ÙÈÎ‹˜

˘ÁÂ›·˜ ÂÈ‰ÈÎÒÓ Î·È ÌË ·ÛıÂÓÒÓ, ·ÔÙ¤ÏÂÛÂ ÙÔ Î‡ÚÈÔ ¤Ó·˘ÛÌ· ÁÈ· ÙËÓ ÂÈÏÔÁ‹ ·˘Ù‹. ŒÙÛÈ, Â-

ÚÈÏ·Ì‚¿ÓÔÓÙ·È Ù¤ÛÛÂÚ· ¿ÚıÚ· Ô˘ ‰È·Ï·Ì‚¿ÓÔÓÙ·È Ù¤ÙÔÈÔ˘ Â›‰Ô˘˜ ˙ËÙ‹Ì·Ù· Î·È ··ÚÙ›˙Ô˘Ó

Î·Ù¿ Î¿ÔÈÔ ÙÚfiÔ Ì›· ÂÓfiÙËÙ·. ™˘ÁÎÂÎÚÈÌ¤Ó· ÛÂ ·˘Ù¿ Û˘ÁÎ·Ù·Ï¤ÁÔÓÙ·È:

ñ Ì›· ÂÚÂ˘ÓËÙÈÎ‹ ÂÚÁ·Û›· ÁÈ· ÙÔÓ Ô‰ÔÓÙÈ·ÙÚÈÎfi Êfi‚Ô Î·È È‰È·›ÙÂÚ· ÁÈ· ÙË Û˘¯ÓfiÙËÙ¿ ÙÔ˘ Î·È

ÙÈ˜ ÂÈÙÒÛÂÈ˜ ÙÔ˘ ÛÙË ÛÙÔÌ·ÙÈÎ‹ ˘ÁÂ›·

ñ ÙÚ›· Â·ÁÁÂÏÌ·ÙÈÎ¿ ı¤Ì·Ù· Û¯ÂÙÈÎ¿ ÌÂ ÙËÓ ÂÈÎÔÈÓˆÓ›· Î·È ÙÈ˜ Û¯¤ÛÂÈ˜ Ô‰ÔÓÙÈ¿ÙÚÔ˘ -

·ÛıÂÓ‹ Î·È Û˘ÁÎÂÎÚÈÌ¤Ó· ÙËÓ ÂÈÎÔÈÓˆÓ›· ÌÂ ÙÔÓ ·ÛıÂÓ‹ Î·Ù¿ ÙËÓ ÎÏÈÓÈÎ‹ Ô‰ÔÓÙÈ·ÙÚÈÎ‹

Ú¿ÍË, ÙËÓ ÂÈÎÔÈÓˆÓ›· Ô‰ÔÓÙÈ¿ÙÚÔ˘ - ËÏÈÎÈˆÌ¤ÓÔ˘ ·ÛıÂÓ‹ Î·È ÙËÓ Û¯¤ÛË Ô‰ÔÓÙÈ¿ÙÚÔ˘ -

·ÛıÂÓ‹ ÌÂ ¤ÌÊ·ÛË ÛÙÔÓ ÂÈ‰ÈÎfi ·ÛıÂÓ‹.

™ÙË Û˘Ó¤¯ÂÈ· ÙÔ˘ ÙfiÌÔ˘ ÂÚÈÏ·Ì‚¿ÓÔÓÙ·È:

ñ Ù¤ÛÛÂÚÂÈ˜ ·Ó·ÛÎÔ‹ÛÂÈ˜, Ì›· ÁÈ· ÙËÓ ¯ÚfiÓÈ· ÓÂÊÚÈÎ‹ ·ÓÂ¿ÚÎÂÈ· Î·È ÙËÓ ÛÙÔÌ·ÙÈÎ‹ ˘ÁÂ›·,

Ì›· ÁÈ· ÙËÓ ÛÙÔÌ·ÙÔ‰˘Ó›·, Ì›· ÁÈ· ÙË Ì·ÁÓËÙÈÎ‹ ÙÔÌÔÁÚ·Ê›· Î·È ÙÈ˜ ÂÊ·ÚÌÔÁ¤˜ ÙË˜ ÛÙËÓ

O‰ÔÓÙÈ·ÙÚÈÎ‹ Î·È Ì›· ÁÈ· ÙËÓ ÌÂÙÂÌÊ‡ÙÂ˘ÛË ÙˆÓ ‰ÔÓÙÈÒÓ

ñ Ì›· ıÂÌ·ÙÈÎ‹ ÂÓfiÙËÙ· ÁÈ· ÙËÓ Ô‰ÔÓÙÈ·ÙÚÈÎ‹ ÊÚÔÓÙ›‰· ÛÂ ¿ÙÔÌ· ÌÂ ·Ó·ËÚ›·.

™ÙÔ Ù¤ÏÔ˜, fiˆ˜ ÚÔ·Ó·Ê¤ÚıËÎÂ, ·ÚÔ˘ÛÈ¿˙ÂÙ·È Ô ·ÔÏÔÁÈÛÌfi˜ ÙÔ˘ 4Ô˘ ¶·ÓÂÏÏËÓ›Ô˘

™˘ÓÂ‰Ú›Ô˘ NÔÛÔÎÔÌÂÈ·Î‹˜ O‰ÔÓÙÈ·ÙÚÈÎ‹˜ Ï·ÈÛÈˆÌ¤ÓÔ˜ ·fi ÊˆÙÔÁÚ·ÊÈÎfi ˘ÏÈÎfi.

AÁ·ËÙÔ› Û˘Ó¿‰ÂÏÊÔÈ,

H «EÏÏËÓÈÎ‹ NÔÛÔÎÔÌÂÈ·Î‹ O‰ÔÓÙÈ·ÙÚÈÎ‹» ¤¯ÂÈ Ï¤ÔÓ Î·ÙÔ¯˘ÚÒÛÂÈ ÙÔ ÚfiÏÔ ÙË˜ ˆ˜ ÊÈÏfiÍÂÓÔ

‚‹Ì· ·ÚÔ˘Û›·ÛË˜ Î·È Î·Ù·ÁÚ·Ê‹˜ ÙÔ˘ ¤ÚÁÔ˘ fiÏˆÓ fiÛÔÈ ˘ËÚÂÙÔ‡Ó ÛÂ NÔÛÔÎÔÌÂ›·,

K¤ÓÙÚ· YÁÂ›·˜ Î·È ¶·ÓÂÈÛÙËÌÈ·Î¤˜ KÏÈÓÈÎ¤˜ Î·È fiÏˆÓ fiÛÔÈ ·Û¯ÔÏÔ‡ÓÙ·È ÌÂ ÙË ‰ËÌfiÛÈ· Î·È

È‰ÈˆÙÈÎ‹ Ô‰ÔÓÙÈ·ÙÚÈÎ‹ ÊÚÔÓÙ›‰· ·ÛıÂÓÒÓ ÌÂ ÂÈ‚¿Ú˘ÓÛË ÙË˜ ÁÂÓÈÎ‹˜ ˘ÁÂ›·˜. OÈ ÂÚÁ·Û›Â˜

Ô˘ ·ÔÛÙ¤ÏÏÂÙÂ ·ÏÏ¿ Î·È ÔÈ ·Ú·ÙËÚ‹ÛÂÈ˜ Î·È ÔÈ È‰¤Â˜ Û·˜, Ì·˜ ÂÓ‰˘Ó·ÌÒÓÔ˘Ó ÛÙÔÓ ·ÁÒ-

Ó· ÁÈ· ÙËÓ ¤ÁÎ˘ÚË Î·È ¯Ú‹ÛÈÌË ÂÓËÌ¤ÚˆÛ‹ Û·˜.

ºÏÒÚ· ZÂÚ‚Ô‡-B¿Ï‚Ë

¶ÚfiÂ‰ÚÔ˜ EENO

¢ÈÂ˘ı˘ÓÙ‹˜ ™‡ÓÙ·ÍË˜

O¢H°IE™ °IA TOY™ ™Y°°PAºEI™

H E§§HNIKH NO™OKOMEIAKH O¢ONTIATPIKH Â›Ó·È ÙÔÂ›ÛËÌÔ ÂÈÛÙËÌÔÓÈÎfi ÂÚÈÔ‰ÈÎfi ÙË˜ EÏÏËÓÈÎ‹˜ EÙ·ÈÚÂ›·˜NÔÛÔÎÔÌÂÈ·Î‹˜ O‰ÔÓÙÈ·ÙÚÈÎ‹˜. ™Ùfi¯Ô˜ ÙË˜ ¤Î‰ÔÛË˜ Â›Ó·ÈË Û‡Á¯ÚÔÓË ÂÓËÌ¤ÚˆÛË ÙˆÓ Û˘Ó·‰¤ÏÊˆÓ ÛÂ ı¤Ì·Ù·NÔÛÔÎÔÌÂÈ·Î‹˜ O‰ÔÓÙÈ·ÙÚÈÎ‹˜ Î·ıÒ˜ Î·È Ë Û˘ÛÙËÌ·ÙÈÎ‹Î·ÏÏÈ¤ÚÁÂÈ· ÙË˜ O‰ÔÓÙÈ·ÙÚÈÎ‹˜ EÈÛÙ‹ÌË˜ ÛÙÔÓ ¯ÒÚÔ ÙˆÓEÏÏËÓÈÎÒÓ NÔÛÔÎÔÌÂ›ˆÓ.

K·ÙËÁÔÚ›Â˜ ÎÂÈÌ¤ÓˆÓTÔ ÂÚÈÔ‰ÈÎfi ‰ËÌÔÛÈÂ‡ÂÈ ÎÂ›ÌÂÓ· Ù· ÔÔ›· ·Ó·Ê¤ÚÔÓÙ·È ÛÂı¤Ì·Ù· NÔÛÔÎÔÌÂÈ·Î‹˜ O‰ÔÓÙÈ·ÙÚÈÎ‹˜ Î·È EÈÛÙËÌÒÓYÁÂ›·˜ ÙˆÓ ·ÎÔÏÔ‡ıˆÓ Î·ÙËÁÔÚÈÒÓ:

1. K‡ÚÈ· ¿ÚıÚ·. ¶ÚfiÎÂÈÙ·È ÁÈ· Â›Î·ÈÚ· ı¤Ì·Ù· Ô˘ÁÚ¿ÊÔÓÙ·È ÌÂ ÚÔÙÚÔ‹ ÙË˜ ™˘ÓÙ·ÎÙÈÎ‹˜ EÈÙÚÔ‹˜·fi O‰ÔÓÙ›·ÙÚÔ ‹ ¿ÏÏÔ ÂÈÛÙ‹ÌÔÓ· ˘ÁÂ›·˜ ÌÂ ÂÈ‰ÈÎ¤˜ÁÓÒÛÂÈ˜.

2. AÓ·ÛÎÔ‹ÛÂÈ˜

3. EÚÂ˘ÓËÙÈÎ¤˜ ÂÚÁ·Û›Â˜

4. ¶Ú·ÎÙÈÎ¿ ı¤Ì·Ù·

5. ¶·ÚÔ˘ÛÈ¿ÛÂÈ˜ ‰Ú·ÛÙËÚÈÔÙ‹ÙˆÓ O‰ÔÓÙÈ·ÙÚÈÎÒÓTÌËÌ¿ÙˆÓ NÔÛÔÎÔÌÂ›ˆÓ

6. EÓ‰È·Ê¤ÚÔ˘ÛÂ˜ ÂÚÈÙÒÛÂÈ˜

7. BÚ·¯Â›Â˜ ‰ËÌÔÛÈÂ‡ÛÂÈ˜ Ô˘ ¤¯Ô˘Ó ¤ÎÙ·ÛË Ì¤¯ÚÈ 2.000-2.500 Ï¤ÍÂÈ˜. A˘Ù¤˜ ı· ‰ËÌÔÛÈÂ‡ÔÓÙ·È Û‡ÓÙÔÌ· Î·È ÌÂ-Ù¿ ·fi ·ÍÈÔÏfiÁËÛË ÙË˜ ™˘ÓÙ·ÎÙÈÎ‹˜ EÈÙÚÔ‹˜.

8. E·ÁÁÂÏÌ·ÙÈÎ¿ ı¤Ì·Ù·

9. EÎ·È‰Â˘ÙÈÎ¿ ı¤Ì·Ù·

10. £ÂÌ·ÙÈÎ¤˜ ÂÓfiÙËÙÂ˜

11. ¶ÂÚÈÏ‹„ÂÈ˜ ¿ÚıÚˆÓ EÏÏ‹ÓˆÓ Ô‰ÔÓÙÈ¿ÙÚˆÓ Ô˘ ¤¯Ô˘Ó‰ËÌÔÛÈÂ˘ıÂ› ÚfiÛÊ·Ù· ÛÂ ÂÈÛÙËÌÔÓÈÎ¿ ¤ÓÙ˘· ÙÔ˘ÂÍˆÙÂÚÈÎÔ‡.

12. EÈÛÙÔÏ¤˜ ÚÔ˜ ÙË ™˘ÓÙ·ÎÙÈÎ‹ EÈÙÚÔ‹, ÔÈ ÔÔ›Â˜·ÊÔÚÔ‡Ó ·) ÎÚ›ÛÂÈ˜ ÁÈ· ÙÔ ÂÚÈÔ‰ÈÎfi ‚) ÎÚ›ÛÂÈ˜ ÁÈ· ‰Ë-ÌÔÛÈÂ˘Ì¤Ó· ¿ÚıÚ·, Á) ÎÚÈÙÈÎ¤˜ ‚È‚Ï›ˆÓ, Î.¿. OÈ ÂÈÛÙÔ-Ï¤˜ ‰ËÌÔÛÈÂ‡ÔÓÙ·È ÌÂÙ¿ ·fi ¤ÁÎÚÈÛË ÙË˜ ™˘ÓÙ·ÎÙÈÎ‹˜EÈÙÚÔ‹˜.

ŒÎÙ·ÛË ¿ÚıÚˆÓ OÈ ·Ó·ÛÎÔ‹ÛÂÈ˜ Ú¤ÂÈ Ó· ¤¯Ô˘Ó ¤ÎÙ·ÛË Ì¤¯ÚÈ 8.000 Ï¤-ÍÂÈ˜ Î·È 80 ‚È‚ÏÈÔÁÚ·ÊÈÎ¤˜ ·Ú·ÔÌ¤˜. OÈ ÂÚÂ˘ÓËÙÈÎ¤˜ÂÚÁ·Û›Â˜ Î·È Ù· Ú·ÎÙÈÎ¿ ı¤Ì·Ù· Ú¤ÂÈ Ó· ¤¯Ô˘Ó ¤ÎÙ·ÛËÌ¤¯ÚÈ 3.500 Ï¤ÍÂÈ˜ Î·È 40 ·Ú·ÔÌ¤˜. OÈ ·ÚÔ˘ÛÈ¿ÛÂÈ˜O‰ÔÓÙÈ·ÙÚÈÎÒÓ TÌËÌ¿ÙˆÓ NÔÛÔÎÔÌÂ›ˆÓ Ú¤ÂÈ Ó· ¤¯Ô˘Ó¤ÎÙ·ÛË Ì¤¯ÚÈ 5.000 Ï¤ÍÂÈ˜. OÈ ÂÓ‰È·Ê¤ÚÔ˘ÛÂ˜ ÂÚÈÙÒÛÂÈ˜Ú¤ÂÈ Ó· ÌËÓ ˘ÂÚ‚·›ÓÔ˘Ó ÙÈ˜ 1.500 Ï¤ÍÂÈ˜. T· Â·ÁÁÂÏ-Ì·ÙÈÎ¿ Î·È ÂÎ·È‰Â˘ÙÈÎ¿ ı¤Ì·Ù· Ú¤ÂÈ Ó· ¤¯Ô˘Ó ¤ÎÙ·ÛËÌ¤¯ÚÈ 5.000 Ï¤ÍÂÈ˜. ™ÙËÓ ¤ÎÙ·ÛË ÙˆÓ ¿ÚıÚˆÓ Û˘ÌÂÚÈÏ·Ì-‚¿ÓÂÙ·È Î·È Ë ‚È‚ÏÈÔÁÚ·Ê›·.

¶ÚÔ‰È·ÁÚ·Ê¤˜ ÎÂÈÌ¤ÓˆÓ1. T· ÎÂ›ÌÂÓ· Ô˘ ˘Ô‚¿ÏÏÔÓÙ·È ÁÈ· ‰ËÌÔÛ›Â˘ÛË Ú¤ÂÈ Ó·Â›Ó·È ÁÚ·ÌÌ¤Ó· ÛÙË ÓÂÔÂÏÏËÓÈÎ‹ ‰ËÌÔÙÈÎ‹ ÁÏÒÛÛ·, ÌÂ ÌÔ-

ÓÔÙÔÓÈÎfi Û‡ÛÙËÌ·. O ‰ÈÔÚıˆÙ‹˜ ÙÔ˘ ÂÚÈÔ‰ÈÎÔ‡ ¤¯ÂÈ ÙÔ ‰È-Î·›ˆÌ· Ó· ÙÚÔÔÔÈÂ› ÁÏˆÛÛÈÎ¿ ÙÔ ÎÂ›ÌÂÓÔ, ¯ˆÚ›˜ fiÌˆ˜Ó· ·ÏÏÔÈÒÓÂÈ ÙÔ ‡ÊÔ˜ ÙÔ˘ Û˘ÁÁÚ·Ê¤·.2. T· ÎÂ›ÌÂÓ· Ú¤ÂÈ Ó· Â›Ó·È ‰·ÎÙ˘ÏÔÁÚ·ÊËÌ¤Ó· ¯·ÚÙ› ÌÂ-Á¤ıÔ˘˜ A4, ÛÂ ‰ÈÏfi ‰È¿ÛÙËÌ·, ÌÂ ÂÚÈıÒÚÈÔ Î·È ·fi ÙÈ˜‰‡Ô ÏÂ˘Ú¤˜ Î·È Ó· ·ÔÛÙ¤ÏÏÔÓÙ·È ÂÈ˜ ÙÚÈÏÔ‡Ó. H ˘Ô‚Ô-Ï‹ ·˘Ù‹ Û˘ÓÔ‰Â‡ÂÙ·È Î·È ·fi ËÏÂÎÙÚÔÓÈÎ‹ ˘Ô‚ÔÏ‹ ÛÂ CD,ÛÙÔ ÔÔ›Ô Ù· ÎÂ›ÌÂÓ· Â›Ó·È ÏËÎÙÚÔÏÔÁËÌ¤Ó· ÛÂ ÚfiÁÚ·Ì-Ì· Word ÌÂ ¯·Ú·ÎÙ‹ÚÂ˜ 12 ÛÙÈÁÌÒÓ. 3. ŸÏÂ˜ ÔÈ Î·ÙËÁÔÚ›Â˜ ÙˆÓ ÎÂÈÌ¤ÓˆÓ ˘Ô‚¿ÏÏÔÓÙ·È ÂÈ˜ ÙÚÈ-ÏÔ‡Ó ÛÙÔÓ ¢ÈÂ˘ı˘ÓÙ‹ ™‡ÓÙ·ÍË˜ ÛÙËÓ ‰ÈÂ‡ı˘ÓÛË:M·˘ÚÔÁ¤ÓÔ˘˜ 32, TK 12461, X·˚‰¿ÚÈ, Aı‹Ó·. 4. ŸÏÂ˜ ÔÈ Î·ÙËÁÔÚ›Â˜ ÙˆÓ ÂÚÁ·ÛÈÒÓ Ú¤ÂÈ Ó· ÂÚÈÏ·Ì‚¿-ÓÔ˘Ó ÙÈ˜ ÂÍ‹˜ ÂÓfiÙËÙÂ˜: i) ™ÂÏ›‰· Ù›ÙÏÔ˘, ii) ÂÚ›ÏË„Ë ÛÙËÓÂÏÏËÓÈÎ‹ Î·È Ï¤ÍÂÈ˜ - ÎÏÂÈ‰È¿, iii) ÎÂ›ÌÂÓÔ ÙË˜ ÂÚÁ·Û›·˜, iv)ÂÚ›ÏË„Ë ÛÙËÓ ·ÁÁÏÈÎ‹ Î·È Ï¤ÍÂÈ˜ - ÎÏÂÈ‰È¿ ÛÙËÓ ·ÁÁÏÈÎ‹,v) ÔÈ ‚È‚ÏÈÔÁÚ·ÊÈÎ¤˜ ·Ú·ÔÌ¤˜, vi) ÏÂ˙¿ÓÙÂ˜, vii) ›Ó·-ÎÂ˜ Î·È viii) ÂÈÎfiÓÂ˜. K¿ıÂ ÂÓfiÙËÙ· ·Ú¯›˙ÂÈ ÌÂ ÍÂ¯ˆÚÈÛÙ‹ÛÂÏ›‰·. H ·Ú›ıÌËÛË fiÏˆÓ ÙˆÓ ÛÂÏ›‰ˆÓ ·ÎÔÏÔ˘ıÂ› ÙËÓ ÚÔ-·Ó·ÊÂÚfiÌÂÓË ÛÂÈÚ¿ ÙˆÓ ÂÓÔÙ‹ÙˆÓ.

™ÂÏ›‰· Ù›ÙÏÔ˘. ¶ÂÚÈÏ·Ì‚¿ÓÂÈ: ·) ÙÔÓ Ù›ÙÏÔ ÙË˜ ÂÚÁ·Û›·˜, ‚)ÙÔ fiÓÔÌ· Î·È ÙÔÓ Ù›ÙÏÔ ÙÔ˘ Û˘ÁÁÚ·Ê¤· ‹ ÙˆÓ Û˘ÁÁÚ·Ê¤ˆÓ,Á) ÙÔ ›‰Ú˘Ì· ÚÔ¤ÏÂ˘ÛË˜ ÙË˜ ÂÚÁ·Û›·˜, ‰) ÙÔ Û˘Ó¤‰ÚÈÔÛÙÔ ÔÔ›Ô ¤¯ÂÈ ÂÓ‰Â¯ÔÌ¤Óˆ˜ ·Ó·ÎÔÈÓˆıÂ› Ë ÂÚÁ·Û›·, Â) ÙÔfiÓÔÌ·, ÙËÓ ‰ÈÂ‡ı˘ÓÛË, ÙÔ ÙËÏ¤ÊˆÓÔ Î·È ÙÔ e-mail ÙÔ˘ Û˘Á-ÁÚ·Ê¤· ÌÂ ÙÔÓ ÔÔ›Ô ı· Á›ÓÂÙ·È Ë ·ÏÏËÏÔÁÚ·Ê›·, ÛÙ) ÙËÓÎ·ÙËÁÔÚ›· ÙË˜ ÂÚÁ·Û›·˜, ˙) ÙËÓ ËÁ‹ ¯ÚËÌ·ÙÔ‰fiÙËÛË˜ÙË˜ ¤ÚÂ˘Ó·˜, Â¿Ó ˘¿Ú¯ÂÈ.

EÏÏËÓÈÎ‹ ÂÚ›ÏË„Ë. ¶ÂÚÈÏ·Ì‚¿ÓÂÈ ÙÔÓ Ù›ÙÏÔ ÙË˜ ÂÚÁ·-Û›·˜, Ù· ÔÓfiÌ·Ù· ÙˆÓ Û˘ÁÁÚ·Ê¤ˆÓ, ÙÔ ÎÂ›ÌÂÓÔ ÙË˜ ÂÚ›ÏË-„Ë˜ Î·È 3-5 Ï¤ÍÂÈ˜ - ÎÏÂÈ‰È¿. H ÂÚ›ÏË„Ë Ú¤ÂÈ Ó· ¤¯ÂÈ¤ÎÙ·ÛË 150-200 Ï¤ÍÂÈ˜. ™ÙÈ˜ ÂÚÂ˘ÓËÙÈÎ¤˜ ÂÚÁ·Û›Â˜, Ë ÂÚ›-ÏË„Ë ÂÚÈÏ·Ì‚¿ÓÂÈ ÙÔÓ ÛÎÔfi, ÙÔ ˘ÏÈÎfi Î·È ÙËÓ Ì¤ıÔ‰Ô, Ù··ÔÙÂÏ¤ÛÌ·Ù· Î·È Ù· Û˘ÌÂÚ¿ÛÌ·Ù·. ™ÙÈ˜ ·Ó·ÛÎÔ‹ÛÂÈ˜ÂÚÈÏ·Ì‚¿ÓÂÈ ÛÙÔÈ¯Â›· ·fi fiÏ· Ù· ÎÂÊ¿Ï·È· ÙË˜ ·Ó·ÛÎfi-ËÛË˜ Î·ıÒ˜ Î·È Ù· Û˘ÌÂÚ¿ÛÌ·Ù·. ™ÙÔ Ù¤ÏÔ˜ ·˘Ù‹˜ ÙË˜ÛÂÏ›‰·˜ ÁÚ¿ÊÔÓÙ·È ÔÈ Ï¤ÍÂÈ˜ ÎÏÂÈ‰È¿, ÔÈ ÔÔ›Â˜ Â›Ó·È ÌÂÌÔ-ÓˆÌ¤ÓÔÈ fiÚÔÈ ‹ ÌÈÎÚ¤˜ ÊÚ¿ÛÂÈ˜ Ô˘ ·ÓÙÈÛÙÔÈ¯Ô‡Ó ÛÙÔ˘˜‰ÈÂıÓÂ›˜ fiÚÔ˘˜ ÏÂÍÈÎÔÁÚ¿ÊËÛË˜ Î·È ·Ó·Ê¤ÚÔÓÙ·È ÛÙÔIndex Medicus Î·È Dental Index.

KÂ›ÌÂÓÔ. OÈ ·Ó·ÛÎÔ‹ÛÂÈ˜ Ú¤ÂÈ Ó· ÂÚÈÏ·Ì‚¿ÓÔ˘Ó ÌÈ·ÂÈÛ·ÁˆÁ‹ ÁÈ· ÙÔ ı¤Ì·, fiÏÂ˜ ÙÈ˜ Û‡Á¯ÚÔÓÂ˜ ‚È‚ÏÈÔÁÚ·ÊÈÎ¿ÙÂÎÌËÚÈˆÌ¤ÓÂ˜ ·fi„ÂÈ˜, ÎÚÈÙÈÎ‹ ·Ó¿Ï˘ÛË ÙˆÓ ·fi„ÂˆÓ·˘ÙÒÓ Î·È Ù· Û˘ÌÂÚ¿ÛÌ·Ù·.OÈ ÂÚÂ˘ÓËÙÈÎ¤˜ ÂÚÁ·Û›Â˜Ú¤ÂÈ Ó· ·ÔÙÂÏÔ‡ÓÙ·È ·fi Ù· ÎÂÊ¿Ï·È·: EÈÛ·ÁˆÁ‹,YÏÈÎfi Î·È M¤ıÔ‰Ô˜, E˘Ú‹Ì·Ù·-AÔÙÂÏ¤ÛÌ·Ù·, ™˘˙‹ÙËÛËÎ·È ™˘ÌÂÚ¿ÛÌ·Ù·. OÈ ÂÓ‰È·Ê¤ÚÔ˘ÛÂ˜ ÂÚÈÙÒÛÂÈ˜ Ú¤-ÂÈ Ó· ·ÔÙÂÏÔ‡ÓÙ·È ·fi ÌÈ· Û‡ÓÙÔÌË ·Ó·ÛÎfiËÛË ÙË˜ ‚È-‚ÏÈÔÁÚ·Ê›·˜, ÌÈ· ÂÎÙÂÓ‹ ·ÚÔ˘Û›·ÛË ÙË˜ ÂÚ›ÙˆÛË˜ Î·ÈÓ· ·ÎÔÏÔ˘ıÂ› Û˘˙‹ÙËÛË. ™ÙÈ˜ ˘fiÏÔÈÂ˜ Î·ÙËÁÔÚ›Â˜ ÙˆÓ¿ÚıÚˆÓ ÙÔ ÎÂ›ÌÂÓÔ ‰È·ÌÔÚÊÒÓÂÙ·È ·Ó¿ÏÔÁ· ÌÂ ÙÈ˜ ··ÈÙ‹-ÛÂÈ˜ ÙÔ˘ ı¤Ì·ÙÔ˜.

BÈ‚ÏÈÔÁÚ·ÊÈÎ¤˜ ·Ú·ÔÌ¤˜. OÈ ‚È‚ÏÈÔÁÚ·ÊÈÎ¤˜ ·Ú·-ÔÌ¤˜ ÛÙÔ ÎÂ›ÌÂÓÔ, ÛÙÔ˘˜ ›Ó·ÎÂ˜ Î·È ÛÙÈ˜ ÏÂ˙¿ÓÙÂ˜ ÙˆÓÂÈÎfiÓˆÓ ÚÔÛ‰ÈÔÚ›˙ÔÓÙ·È ÌÂ ·Ú·‚ÈÎÔ‡˜ ·ÚÈıÌÔ‡˜ ÛÂ ·-Ú¤ÓıÂÛË. H ·Ú›ıÌËÛË ÙˆÓ ‚È‚ÏÈÔÁÚ·ÊÈÎÒÓ ·Ú·ÔÌÒÓÁ›ÓÂÙ·È Î·Ù ·‡ÍÔÓÙ· ·ÚÈıÌfi ÌÂ ÙËÓ ÛÂÈÚ¿ Ô˘ ·˘Ù¤˜ ÂÌÊ·-Ó›˙ÔÓÙ·È ÛÙÔ ÎÂ›ÌÂÓÔ. ŸÏÂ˜ ÔÈ ‚È‚ÏÈÔÁÚ·ÊÈÎ¤˜ ·Ú·ÔÌ¤˜Ô˘ ·Ó·Ê¤ÚÔÓÙ·È ÛÙÔ ÎÂ›ÌÂÓÔ, ·Ó·ÁÚ¿ÊÔÓÙ·È ÛÙÔÓ ‚È‚ÏÈÔ-ÁÚ·ÊÈÎfi Î·Ù¿ÏÔÁÔ, Ô ÔÔ›Ô˜ ·Ú¯›˙ÂÈ ÛÂ ÍÂ¯ˆÚÈÛÙ‹ ÛÂÏ›‰·ÌÂÙ¿ ÙÔ ÎÂ›ÌÂÓÔ. OÈ Û˘ÓÙÌ‹ÛÂÈ˜ ÙˆÓ Ù›ÙÏˆÓ ÂÚÈÔ‰ÈÎÒÓ Ú¤ÂÈ Ó· ÁÚ¿ÊÔÓÙ·ÈÛ‡ÌÊˆÓ· ÌÂ ÙÔ Dental Index Î·È Index Medicus. °È· ÙÈ˜ Û˘-ÓÙÌ‹ÛÂÈ˜ ÙˆÓ ÂÏÏËÓÈÎÒÓ ÂÚÈÔ‰ÈÎÒÓ ÔÈ Û˘ÁÁÚ·ÊÂ›˜ Ú¤ÂÈÓ· Û˘Ì‚Ô˘ÏÂ‡ÔÓÙ·È ÙÔÓ Û¯ÂÙÈÎfi Î·Ù¿ÏÔÁÔ ÙÔ˘ IATPOTEK. ¶·Ú·‰Â›ÁÌ·Ù· ÁÚ·Ê‹˜ ÙˆÓ ‚È‚ÏÈÔÁÚ·ÊÈÎÒÓ ·Ú·ÔÌÒÓ:¶ÂÚÈÔ‰ÈÎfi: AÓ·Ê¤ÚÔÓÙ·È ÌÂ ÙËÓ ÛÂÈÚ¿ Ù· ÂÒÓ˘Ì· Î·È Ù··Ú¯ÈÎ¿ ÙˆÓ ÔÓÔÌ¿ÙˆÓ ÙˆÓ Û˘ÁÁÚ·Ê¤ˆÓ Ì¤¯ÚÈ ¤ÍË (fiÙ·Ó Â›-Ó·È ÂÚÈÛÛfiÙÂÚÔÈ ·ÎÔÏÔ˘ıÂ› Ë ¤Ó‰ÂÈÍË «et al» ÚÔÎÂÈÌ¤ÓÔ˘ÁÈ· ÍÂÓfiÁÏˆÛÛ· ¿ÚıÚ· ‹ «Î·È Û˘Ó.» ÚÔÎÂÈÌ¤ÓÔ˘ ÁÈ· ÂÏÏË-ÓÈÎ¿ ¿ÚıÚ·), Ô Ù›ÙÏÔ˜ ÙË˜ ÂÚÁ·Û›·˜, Ë Û˘ÓÙÔÌÔÁÚ·Ê›· ÙÔ˘ÂÚÈÔ‰ÈÎÔ‡, ÙÔ ¤ÙÔ˜, Ô ÙfiÌÔ˜, ÙÔ ÙÂ‡¯Ô˜, Ë ÚÒÙË Î·È Ë ÙÂ-ÏÂ˘Ù·›· ÛÂÏ›‰· ÙË˜ ‰ËÌÔÛ›Â˘ÛË˜. ¶.¯. Ettinger RL:Rational Dental Care: Part 1. Has the concept changed in20 years? J Can Dent Assoc 2006; 72(5): 441-445.™ËÌÂÈˆÙ¤ÔÓ fiÙÈ Ë Û˘ÓÙÔÌÔÁÚ·Ê›· ÙÔ˘ ÂÚÈÔ‰ÈÎÔ‡ EÏÏËÓÈÎ‹NÔÛÔÎÔÌÂÈ·Î‹ O‰ÔÓÙÈ·ÙÚÈÎ‹ Â›Ó·È EÏÏ NÔÛ O‰ÔÓÙ.BÈ‚Ï›Ô, ÂÁ¯ÂÈÚ›‰ÈÔ, ÌÔÓÔÁÚ·Ê›·: AÓ·Ê¤ÚÔÓÙ·È ÌÂ ÙËÓ ÛÂÈÚ¿Ù· ÂÒÓ˘Ì· Î·È ·Ú¯ÈÎ¿ ÙˆÓ ÔÓÔÌ¿ÙˆÓ ÙˆÓ Û˘ÁÁÚ·Ê¤ˆÓ, ÔÙ›ÙÏÔ˜ ÙÔ˘ ‚È‚Ï›Ô˘, Ô ·ÚÈıÌfi˜ ¤Î‰ÔÛË˜, Ë fiÏË ¤Î‰ÔÛË˜, ÔÂÎ‰fiÙË˜, ÙÔ ¤ÙÔ˜, ¿Óˆ - Î¿Ùˆ ÙÂÏÂ›· Î·È Ë ÛÂÏ›‰·. ¶.¯. LittleJW, Falace DA, Miller CS, Rhodus NL: Dental Management.5th ed. St. Louis. Mosby. 1997: 274.AÓ Ë ‚È‚ÏÈÔÁÚ·ÊÈÎ‹ ·Ú·ÔÌ‹ ·ÔÙÂÏÂ› ÎÂÊ¿Ï·ÈÔ ÂÓfi˜ ‚È-‚Ï›Ô˘ Ô˘ ¤¯ÂÈ ÁÚ·ÊÂ› ·fi ¿ÏÏÔ Û˘ÁÁÚ·Ê¤·, Ë ·Ó·ÊÔÚ¿ Á›-ÓÂÙ·È ˆ˜ ÂÍ‹˜: Mitchell PF: Pain Management in the Hospital.In: Zambito RF, Black HA, Tesch LB, eds. Hospital DentistryPractice and Education. St. Louis. Mosby. 1997: 223-242.IÛÙÔÛÂÏ›‰Â˜:http://www.dentalcare.com/soap/intermed/conhea.htm,fiˆ˜ ·˘Ùfi ÂÌÊ·Ó›˙ÂÙ·È ÙËÓ .............. (ËÌÂÚÔÌËÓ›· ·Ó·˙‹-ÙËÛË˜).

AÁÁÏÈÎ‹ ÂÚ›ÏË„Ë. ¶ÂÚÈÏ·Ì‚¿ÓÂÈ ÙÔÓ Ù›ÙÏÔ ÙË˜ ÂÚÁ·Û›·˜,Ù· ÔÓfiÌ·Ù· ÙˆÓ Û˘ÁÁÚ·Ê¤ˆÓ, ÙÔ ÎÂ›ÌÂÓÔ ÙË˜ ÂÚ›ÏË„Ë˜Î·È 3-5 Ï¤ÍÂÈ˜ - ÎÏÂÈ‰È¿. H ¤ÎÙ·ÛË ÙˆÓ ÂÚÈÏ‹„ÂˆÓ ı· Ú¤-ÂÈ Ó· Î˘Ì·›ÓÂÙ·È ÌÂÙ·Í‡ 300 Î·È 350 Ï¤ÍÂˆÓ. K·Ù¿ Ù· ¿Ï-Ï· ÈÛ¯‡Ô˘Ó Ù· ·Ó·ÊÂÚfiÌÂÓ· ÛÙËÓ ÂÏÏËÓÈÎ‹ ÂÚ›ÏË„Ë.

¶›Ó·ÎÂ˜. ¢·ÎÙ˘ÏÔÁÚ·ÊÔ‡ÓÙ·È ÛÂ ¯ˆÚÈÛÙ‹ ÛÂÏ›‰· Ô˘ Â-ÚÈÏ·Ì‚¿ÓÂÈ Î·È ÙË ÏÂ˙¿ÓÙ·. AÚÈıÌÔ‡ÓÙ·È ÌÂ ·Ú·‚ÈÎÔ‡˜·ÚÈıÌÔ‡˜ Ô˘ ·Ó·Ê¤ÚÔÓÙ·È ÛÙÔ ÎÂ›ÌÂÓÔ. OÈ ÂÂÍËÁ‹ÛÂÈ˜ÙˆÓ Û˘ÓÙÔÌÔÁÚ·ÊÈÒÓ Î·È ÔÈ Ù˘¯fiÓ ··ÈÙÔ‡ÌÂÓÂ˜ ‰ÈÂ˘ÎÚÈÓ›-ÛÂÈ˜, ·Ó·ÁÚ¿ÊÔÓÙ·È ÛÙÔ Ù¤ÏÔ˜ ÙÔ˘ ›Ó·Î·.

EÈÎfiÓÂ˜. T· Û¯‹Ì·Ù·, Ù· ‰È·ÁÚ¿ÌÌ·Ù· Î·È ÔÈ ÊˆÙÔÁÚ·-Ê›Â˜ Ú¤ÂÈ Ó· Ó· ÌËÓ ÂÌÂÚÈ¤¯ÔÓÙ·È ÛÙËÓ ÚÔ‹ ÙÔ˘ ÎÂÈÌ¤-ÓÔ˘ ÙË˜ ÂÚÁ·Û›·˜ Î·È Ó· ·ÔÛÙ¤ÏÏÔÓÙ·È ÛÙÔ ÚˆÙfiÙ˘Ô(ÂÈ˜ ÙÚÈÏÔ‡Ó). A˘Ù¿ Î·Ù·Ù›ıÂÓÙ·È ÙfiÛÔ ËÏÂÎÙÚÔÓÈÎ¿(CD) ÛÂ ÌÔÚÊ‹ ·Ú¯Â›ˆÓ JPG fiÛÔ Î·È ÌÂ ÂÎÙ˘ˆÌ¤Ó··ÓÙ›ÁÚ·Ê·.™ÙÔ ›Ûˆ ¿Óˆ ‰ÂÍÈfi Ì¤ÚÔ˜ ÁÚ¿ÊÂÙ·È ÌÂ ÌÔÏ‡‚È Ô ·ÚÈıÌfi˜ÙË˜ ÂÈÎfiÓ·˜. K¿ıÂ ÛÂÈÚ¿ ÊˆÙÔÁÚ·ÊÈÒÓ ÙÔÔıÂÙÂ›Ù·È ÛÂ ÍÂ-¯ˆÚÈÛÙfi Ê¿ÎÂÏÔ ÌÂ Ù· ÔÓfiÌ·Ù· ÙˆÓ Û˘ÁÁÚ·Ê¤ˆÓ ·Ó·ÁÂ-ÁÚ·ÌÌ¤Ó· Â› ·˘ÙÔ‡. OÈ ÏÂ˙¿ÓÙÂ˜ ÙˆÓ ÂÈÎfiÓˆÓ ÁÚ¿ÊÔÓÙ·È ÛÂ ÍÂ¯ˆÚÈÛÙ‹ ÛÂÏ›‰·ÌÂ ÙÔÓ ·‡ÍÔÓÙ· ·ÚÈıÌfi ÙÔ˘˜. EÈÛËÌ·›ÓÂÙ·È fiÙÈ Â¿Ó ÛÙÈ˜ ÂÈÎfiÓÂ˜ ÂÌÊ·Ó›˙ÂÙ·È ÙÔ ÚfiÛˆ-Ô ÙÔ˘ ·ÛıÂÓÔ‡˜, Ë ™˘ÓÙ·ÎÙÈÎ‹ EÈÙÚÔ‹ Î·Ù¿ ÙË ‰ËÌÔÛ›-Â˘ÛË ı· Î·Ï‡ÙÂÈ ÙÔ˘˜ ÔÊı·ÏÌÔ‡˜ ÌÂ Ì·‡ÚË Ù·ÈÓ›· ÁÈ· Ïfi-ÁÔ˘˜ ÛÂ‚·ÛÌÔ‡ ÙˆÓ ÚÔÛˆÈÎÒÓ ‰Â‰ÔÌ¤ÓˆÓ.Y¿Ú¯ÂÈ ‰˘Ó·ÙfiÙËÙ· ÂÎÙ‡ˆÛË˜ ¤Á¯ÚÒÌˆÓ ÂÈÎfiÓˆÓ ÌÂÙ¿·fi Û˘ÓÂÓÓfiËÛË ÌÂ ÙÔÓ ¢ÈÂ˘ı˘ÓÙ‹ ™‡ÓÙ·ÍË˜.

KÚ›ÛË - ‰ËÌÔÛ›Â˘ÛË ÂÚÁ·Û›·˜H ÎÚ›ÛË ÙˆÓ ÂÚÁ·ÛÈÒÓ Á›ÓÂÙ·È ·fi ‰‡Ô ÎÚÈÙ¤˜ ÔÈ ÔÔ›ÔÈ ÂÈ-Ï¤ÁÔÓÙ·È ·fi ÙËÓ ™˘ÓÙ·ÎÙÈÎ‹ EÈÙÚÔ‹. H ™˘ÓÙ·ÎÙÈÎ‹EÈÙÚÔ‹ ¤¯ÂÈ ÙÔ ‰ÈÎ·›ˆÌ· Ó· ÚÔÙÂ›ÓÂÈ ÙÚÔÔÔÈ‹ÛÂÈ˜ ‹Ó· ·ÔÚÚ›ÙÂÈ Ù· ¿ÚıÚ· Ô˘ ‰ÂÓ ˘Ô‚¿ÏÏÔÓÙ·È ÁÚ·ÌÌ¤Ó·Û‡ÌÊˆÓ· ÌÂ ÙÈ˜ ·ÓˆÙ¤Úˆ Ô‰ËÁ›Â˜.

EÈ‰ÈÎ¤˜ ÂÈÛËÌ¿ÓÛÂÈ˜ °È· ÙËÓ ·Ú·Ï·‚‹ Î¿ıÂ ÂÈÛÙËÌÔÓÈÎ‹˜ ÂÚÁ·Û›·˜ ÁÈ· ‰ËÌÔ-Û›Â˘ÛË, ÂÈÛ˘Ó¿ÙÂÙ·È ˘Ô¯ÚÂˆÙÈÎ¿ ÂÓ˘fiÁÚ·ÊË ‰È·‚Â-‚·›ˆÛË ÙˆÓ Û˘ÁÁÚ·Ê¤ˆÓ fiÙÈ Ë ÂÚÁ·Û›· ‰ÂÓ ¤¯ÂÈ Î·Ù·ÙÂıÂ›ÛÂ ¿ÏÏÔ ÂÈÛÙËÌÔÓÈÎfi ÂÚÈÔ‰ÈÎfi, Â›ÛË˜ fiÙÈ ‰ÂÓ ÂÚÈ¤¯ÂÈ·˘ÙÔ‡ÛÈÂ˜ ÚÔÙ¿ÛÂÈ˜ ·fi ¿ÏÏÂ˜ ÂÈÛÙËÌÔÓÈÎ¤˜ ‰ËÌÔÛÈÂ‡-ÛÂÈ˜ (ÂÎÙfi˜ ·fi ÔÚÈÛÌÔ‡˜, ÓfiÌÔ˘˜, ‰È·Ù¿ÍÂÈ˜ Î·È Î·ÓfiÓÂ˜)Î·ıÒ˜ Î·È fiÙÈ ÙÔ ÊˆÙÔÁÚ·ÊÈÎfi ˘ÏÈÎfi Â›Ó·È Â›ÙÂ ›‰ÈÔ Â›ÙÂ ÌÂ-Ù·Û¯Â‰È·ÛÌ¤ÓÔ.T· ‰ËÌÔÛÈÂ˘Ì¤Ó· ¿ÚıÚ·, ÙˆÓ ÂÈÎfiÓˆÓ Û˘ÌÂÚÈÏ·Ì‚·ÓÔÌ¤-ÓˆÓ, ·ÔÙÂÏÔ‡Ó È‰ÈÔÎÙËÛ›· ÙÔ˘ ÂÚÈÔ‰ÈÎÔ‡. ¶ÚÔÎÂÈÌ¤ÓÔ˘Ó· ·Ó·‰ËÌÔÛÈÂ˘ıÔ‡Ó ··ÈÙÂ›Ù·È Ë ¿‰ÂÈ· ÙË˜ ™˘ÓÙ·ÎÙÈÎ‹˜EÈÙÚÔ‹˜ Î·È ÙÔ˘ Û˘ÁÁÚ·Ê¤·.

EI™A°ø°HO Êfi‚Ô˜ ÙÔ˘ fiÓÔ˘ Î·È ÙÔ ¿Á¯Ô˜ ÁÈ· ÙÔÓ Ô‰ÔÓÙ›·ÙÚÔÊ·›ÓÂÙ·È Ó· ¤¯Ô˘Ó ··Û¯ÔÏ‹ÛÂÈ ÔÏÏÔ‡˜ ÂÚÂ˘ÓËÙ¤˜ ÔÈÔÔ›ÔÈ Ù· ÂÚÈÁÚ¿ÊÔ˘Ó ˆ˜ Ô‰ÔÓÙÈ·ÙÚÈÎfi Êfi‚Ô (dentalfear), Ô‰ÔÓÙÈ·ÙÚÈÎfi ¿Á¯Ô˜ (dental anxiety), Ô‰oÓÙÈ·ÙÚÈ-Î‹ ÊÔ‚›· (dental phobia)1-6. AÓ Î·È ‰Â Ê·›ÓÂÙ·È Ó· ̆ ¿Ú-¯ÂÈ Û·Ê‹˜ ‰È¿ÎÚÈÛË ÌÂÙ·Í‡ Ô‰ÔÓÙÈ·ÙÚÈÎÔ‡ Êfi‚Ô˘ Î·È

¿Á¯Ô˘˜, ·ÊÔ‡ ·Ó·Ê¤ÚÂÙ·È fiÙÈ ¤¯Ô˘Ó ÎÔÈÓ¿ Û˘ÌÙÒÌ·-Ù· Î·È Û˘Ó¤ÂÈÂ˜, ˘ÔÛÙËÚ›˙ÂÙ·È fiÙÈ Ë ‰È·ÊÔÚ¿ ÌÂÙ·Í‡Ô‰ÔÓÙÈ·ÙÚÈÎÔ‡ Êfi‚Ô˘ Î·È Ô‰oÓÙÈ·ÙÚÈÎ‹˜ ÊÔ‚›·˜ Â›Ó·ÈfiÙÈ ÛÙËÓ ÚÒÙË ÂÚ›ÙˆÛË, ·Ó Î·È Ù· ¿ÙÔÌ· ÊÔ‚Ô‡ÓÙ·ÈÙÂÏÈÎ¿ ÂÈÛÎ¤ÙÔÓÙ·È ÙÔÓ Ô‰ÔÓÙ›·ÙÚÔ, ¤ÛÙˆ ÌÈ· ÊÔÚ¿Î¿ıÂ ‰‡Ô ¯ÚfiÓÈ·1,2,5-7. ™ÙË ‰Â‡ÙÂÚË ÂÚ›ÙˆÛË, Ë Ï‹-ÚË˜ ·ÔÊ˘Á‹ ÙË˜ Ô‰ÔÓÙÈ·ÙÚÈÎ‹˜ ıÂÚ·Â›·˜, ÂÔÌ¤Óˆ˜Î·È ÙÔ˘ ÊÔ‚ÈÎÔ‡ ÂÚÂı›ÛÌ·ÙÔ˜ ‰Â›¯ÓÂÈ Ó· Û˘ÌÊˆÓÂ› ÌÂÙ· ‰È·ÁÓˆÛÙÈÎ¿ ÎÚÈÙ‹ÚÈ· ÁÈ· ÙË ÊÔ‚›· ÙË˜ AÌÂÚÈÎ·ÓÈ-Î‹˜ æ˘¯È·ÙÚÈÎ‹˜ ŒÓˆÛË˜ (DSM-IV)5,6. ™‡ÌÊˆÓ· ÌÂ ÙÔ˘˜ ÂÚÂ˘ÓËÙ¤˜ Locker Î·È Û˘Ó7, ArmfieldÎ·È Û˘Ó5,6, Greenberg8, Belzung Î·È Chevalley9 Ô˘ ıÂ-ˆÚÔ‡Ó fiÙÈ Ô Êfi‚Ô˜ Â›Ó·È ¤Ó· ‚·ÛÈÎfi ·ÓıÚÒÈÓÔ Û˘Ó·›-ÛıËÌ· ÂÓÒ ÙÔ ¿Á¯Ô˜ ‰Â˘ÙÂÚÔÁÂÓ¤˜, ˆ˜ Ô‰ÔÓÙÈ·ÙÚÈÎfi˜Êfi‚Ô˜ ÂÚÈÁÚ¿ÊÂÙ·È Ë Î·Ù¿ÛÙ·ÛË Ô˘ ÂÌÂÚÈ¤¯ÂÈ Û˘-Ó·ÈÛı‹Ì·Ù· ¤ÓÙ·ÛË˜, Êfi‚Ô˘, ¿Á¯Ô˘˜ Ô˘ ¤¯ÂÈ ̂ ˜ ·Ô-Ù¤ÏÂÛÌ· ÙËÓ ·ÚÔı˘Ì›· ÙˆÓ ·ÛıÂÓÒÓ Ó· ‰È·ÙËÚ‹ÛÔ˘ÓÛÙ·ıÂÚ‹ Û¯¤ÛË ÌÂ ÙËÓ Ô‰ÔÓÙÈ·ÙÚÈÎ‹ ÊÚÔÓÙ›‰· ‹ Î·ıÈ-

EÚÂ˘ÓËÙÈÎ‹ ÂÚÁ·Û›·

O‰ÔÓÙÈ·ÙÚÈÎfi˜ Êfi‚Ô˜™˘¯ÓfiÙËÙ· Î·È ÂÈÙÒÛÂÈ˜

ÛÙËÓ ÛÙÔÌ·ÙÈÎ‹ ˘ÁÂ›· ÂÓËÏ›ÎˆÓ ·ÛıÂÓÒÓAÓ‰ÚÈ·Ó‹ KÔÎÎÔÚ¤1, AÈÎ·ÙÂÚ›ÓË ¢ÔÓÙ¿2 , K·›ÙË NÈÎÔÔ‡ÏÔ˘-K·Ú·ÁÈ¿ÓÓË3

™KO¶O™: Ó· Û˘Û¯ÂÙ›ÛÂÈ ÙÔÓ Ô‰ÔÓÙÈ·ÙÚÈÎfi Êfi‚Ô ÌÂ ÙË ÛÙÔÌ·ÙÈÎ‹ ˘ÁÂ›· Î·È ÌÂ ÔÚÈÛÌ¤Ó· ÂÈ‰ËÌÈÔ-ÏÔÁÈÎ¿ ¯·Ú·ÎÙËÚÈÛÙÈÎ¿ fiˆ˜ ÙÔ Ê‡ÏÔ, ÙËÓ ËÏÈÎ›·, ÙË ÌfiÚÊˆÛË, ÙÔÓ ÙfiÔ ‰È·ÌÔÓ‹˜ Î·È Ó· ·ÍÈÔÏÔ-Á‹ÛÂÈ ÙË Û¯¤ÛË ÙÔ˘ ÌÂ ÙË Û˘¯ÓfiÙËÙ· Î·È ·ÈÙ›· ÚÔÛ¤ÏÂ˘ÛË˜ ÛÙÔÓ Ô‰ÔÓÙ›·ÙÚÔ. Y§IKA-ME£O¢OI: 101 ÂÓ‹ÏÈÎÂ˜ ·ÛıÂÓÂ›˜ Û˘ÌÏ‹ÚˆÛ·Ó ÂÚˆÙËÌ·ÙÔÏfiÁÈÔ ÙÔ ÔÔ›Ô ÂÚÈÂÏ¿Ì‚·ÓÂ‰‡Ô Ì¤ÙÚ· ÂÎÙ›ÌËÛË˜ ÙÔ˘ Ô‰ÔÓÙÈ·ÙÚÈÎÔ‡ Êfi‚Ô˘ (MDAS Î·È FS) Î·È ÂÚˆÙ‹ÛÂÈ˜ Û¯ÂÙÈÎ¿ ÌÂ ÔÚÈÛÌ¤Ó·ÂÈ‰ËÌÈÔÏÔÁÈÎ¿ ¯·Ú·ÎÙËÚÈÛÙÈÎ¿, ÙË Û˘¯ÓfiÙËÙ· Î·È ·ÈÙ›· Â›ÛÎÂ„Ë˜ ÛÙÔÓ Ô‰ÔÓÙ›·ÙÚÔ. H ÛÙÔÌ·ÙÈÎ‹Î·Ù¿ÛÙ·ÛË ÙˆÓ ·ÛıÂÓÒÓ ·ÍÈÔÏÔÁ‹ıËÎÂ ÌÂÙ¿ ÙËÓ ÎÏÈÓÈÎ‹ Î·È ·ÎÙÈÓÔÁÚ·ÊÈÎ‹ ÂÍ¤Ù·ÛË ÙˆÓ ·ÛıÂÓÒÓ.A¶OTE§E™MATA: H Û˘¯ÓfiÙËÙ· ÙÔ˘ ˘ÂÚ‚ÔÏÈÎÔ‡ Ô‰ÔÓÙÈ·ÙÚÈÎÔ‡ Êfi‚Ô˘ fiˆ˜ ÂÎÙÈÌ‹ıËÎÂ ·Ô ÙËÓFS Î·È MDAS ‹Ù·Ó 13,86% Î·È 14,85% ·ÓÙ›ÛÙÔÈ¯·. ™˘ÓÔÏÈÎ¿ ÙÔ 37,62% -Û‡ÌÊˆÓ· ÌÂ ÙËÓ FS Î·È ÙÔ33,66% -Û‡ÌÊˆÓ· ÌÂ ÙËÓ MDAS- ÙˆÓ ·ÛıÂÓÒÓ ·Ó¤ÊÂÚÂ Ì¤ÙÚÈÔ ̂ ˜ ̆ ÂÚ‚ÔÏÈÎfi Ô‰ÔÓÙÈ·ÙÚÈÎfi Êfi‚Ô.BÚ¤ıËÎÂ ıÂÙÈÎ‹ Û˘Û¯¤ÙÈÛË ÌÂÙ·Í‡ FS Î·È MDAS ÛÂ Â›Â‰Ô ÛÙ·ÙÈÛÙÈÎ‹˜ ÛËÌ·ÓÙÈÎfiÙËÙ·˜ 5%. OÈ Á˘-Ó·›ÎÂ˜ ·Ó¤ÊÂÚ·Ó fiÙÈ ÊÔ‚Ô‡ÓÙ·È ÂÚÈÛÛfiÙÂÚÔ ÛÂ Û¯¤ÛË ÌÂ ÙÔ˘˜ ¿Ó‰ÚÂ˜ ÛÂ ‚·ıÌfi ÛÙ·ÙÈÛÙÈÎ¿ ÛË-Ì·ÓÙÈÎfi. ¶·Ú·ÙËÚ‹ıËÎÂ ·ÚÓËÙÈÎ‹ Û˘Û¯¤ÙÈÛË ÌÂÙ·Í‡ Ô‰ÔÓÙÈ·ÙÚÈÎÔ‡ Êfi‚Ô˘ Î·È ËÏÈÎ›·˜ ÛÂ ‚·ıÌfiÛÙ·ÙÈÛÙÈÎ¿ ÛËÌ·ÓÙÈÎfi. ¢ÂÓ ·Ú·ÙËÚ‹ıËÎÂ ÛÙ·ÙÈÛÙÈÎ¿ ÛËÌ·ÓÙÈÎ‹ Û¯¤ÛË ÌÂÙ·Í‡ Ô‰ÔÓÙÈ·ÙÚÈÎÔ‡ Êfi-‚Ô˘ Î·È ÌfiÚÊˆÛË˜, ÙfiÔ˘ ‰È·ÌÔÓ‹˜, Û˘¯ÓfiÙËÙ·˜ Î·È ·ÈÙ›·˜ Â›ÛÎÂ„Ë˜ ÛÙÔÓ Ô‰ÔÓÙ›·ÙÚÔ. £ÂÙÈÎ‹Û˘Û¯¤ÙÈÛË ·Ú·ÙËÚ‹ıËÎÂ ÌÂÙ·Í‡ Ô‰ÔÓÙÈ·ÙÚÈÎÔ‡ Êfi‚Ô˘ Î·È ·ÚÈıÌÔ‡ ÂÏÏÂÈfiÓÙˆÓ ‰ÔÓÙÈÒÓ Î·È ·Ú-ÓËÙÈÎ‹ Û˘Û¯¤ÙÈÛË ÌÂÙ·Í‡ ÙÔ˘ Êfi‚Ô˘ Î·È ÙÔ˘ ·ÚÈıÌÔ‡ ÙˆÓ ÂÌÊÚ·¯ı¤ÓÙˆÓ ‰ÔÓÙÈÒÓ, ÛÂ ‚·ıÌfi ÛÙ·ÙÈ-ÛÙÈÎ¿ ÛËÌ·ÓÙÈÎfi. ™YM¶EPA™MATA: H Û˘¯ÓfiÙËÙ· ÙÔ˘ Ô‰ÔÓÙÈ·ÙÚÈÎÔ‡ Êfi‚Ô˘ ÛÂ ‰Â›ÁÌ· ÂÓËÏ›ÎˆÓ ·ÛıÂÓÒÓ Ê·›ÓÂÙ·È ̆ -„ËÏ‹. O Ô‰ÔÓÙÈ·ÙÚÈÎfi˜ Êfi‚Ô˜ ‰Â›¯ÓÂÈ Ó· Û¯ÂÙ›˙ÂÙ·È ÌÂ ÔÚÈÛÌ¤Ó· ÂÈ‰ËÌÈÔÏÔÁÈÎ¿ ¯·Ú·ÎÙËÚÈÛÙÈÎ¿fiˆ˜ ÙÔ Ê‡ÏÔ Î·È ÙËÓ ËÏÈÎ›· ·ÏÏ¿ ‰ÂÓ ‚Ú¤ıËÎÂ Ó· Û¯ÂÙ›˙ÂÙ·È ÌÂ ÙË ÌfiÚÊˆÛË Î·È ÙÔÓ ÙfiÔ ‰È·ÌÔ-Ó‹˜ Î·È Ê·›ÓÂÙ·È Ó· ¤¯ÂÈ ‰˘ÛÌÂÓÂ›˜ ÂÈÙÒÛÂÈ˜ ÛÙË ÛÙÔÌ·ÙÈÎ‹ ˘ÁÂ›· ÙˆÓ ·ÛıÂÓÒÓ.

ÂÏÏËÓÈÎ‹ ÓÔÛÔÎÔÌÂÈ·Î‹ Ô‰ÔÓÙÈ·ÙÚÈÎ‹ 4: 11-17, 2011

§¤ÍÂÈ˜ ÎÏÂÈ‰È¿: O‰ÔÓÙÈ·ÙÚÈÎfi˜ Êfi‚Ô˜, ÛÙÔÌ·ÙÈÎ‹ ˘ÁÂ›·, ÂÓ‹ÏÈÎÂ˜ ·ÛıÂÓÂ›˜

1 O‰ÔÓÙ›·ÙÚÔ˜, ™˘ÓÂÚÁ¿ÙË˜ ¢È·ÁÓˆÛÙÈÎ‹˜ Î·È AÎÙÈÓÔÏÔÁ›·˜ ™ÙfiÌ·ÙÔ˜, O‰ÔÓÙÈ·ÙÚÈÎ‹ ™¯ÔÏ‹, EK¶A

2 E›ÎÔ˘ÚË K·ıËÁ‹ÙÚÈ· ¢È·ÁÓˆÛÙÈÎ‹˜ Î·È AÎÙÈÓÔÏÔÁ›·˜™ÙfiÌ·ÙÔ˜, O‰ÔÓÙÈ·ÙÚÈÎ‹ ™¯ÔÏ‹, EK¶A

3 K·ıËÁ‹ÙÚÈ· ¢È·ÁÓˆÛÙÈÎ‹˜ Î·È AÎÙÈÓÔÏÔÁ›·˜ ™ÙfiÌ·ÙÔ˜,O‰ÔÓÙÈ·ÙÚÈÎ‹ ™¯ÔÏ‹, EK¶A

ÿ‰Ú˘Ì· ÚÔ¤ÏÂ˘ÛË˜ ÂÚÁ·Û›·˜: O‰ÔÓÙÈ·ÙÚÈÎ‹ ™¯ÔÏ‹, EK¶A

11

ÛÙ¿ ÙËÓ Ô‰ÔÓÙÈ·ÙÚÈÎ‹ Â›ÛÎÂ„Ë È‰È·›ÙÂÚ· ‰˘Û¿ÚÂÛÙË.ø˜ ·ÈÙÈÔÏÔÁÈÎÔ› ·Ú¿ÁÔÓÙÂ˜ ¤¯Ô˘Ó ·Ó·ÊÂÚıÂ› Ô fiÓÔ˜Î·Ù¿ ÙËÓ Ô‰ÔÓÙÈ·ÙÚÈÎ‹ ıÂÚ·Â›·, Ë ÚÔËÁÔ‡ÌÂÓË ÙÚ·˘-Ì·ÙÈÎ‹ ÂÌÂÈÚ›·, Ë ÙÔÈÎ‹ ·Ó·ÈÛıËÛ›· (ı¤· ÙË˜ ‚ÂÏfi-Ó·˜), ÔÏÈÙÈÛÙÈÎÔ› Î·È ÎÔÈÓˆÓÈÎÔ› ÏfiÁÔÈ, Ù· È‰È·›ÙÂÚ· Û˘-Ó·ÈÛıËÌ·ÙÈÎ¿ ÁÓˆÚ›ÛÌ·Ù· ÙÔ˘ ·ÛıÂÓ‹3,10-14. ™ËÌ·ÓÙÈÎfi˜Ê·›ÓÂÙ·È Ó· Â›Ó·È Î·È Ô ÚfiÏÔ˜ ÙË˜ ÔÈÎÔÁ¤ÓÂÈ·˜ Î·È ÙÔ˘Ô‰ÔÓÙÈ¿ÙÚÔ˘10-14. ™ËÌÂ›· Î·È Û˘ÌÙÒÌ·Ù· Ô˘ ¤¯Ô˘Ó ·-Ú·ÙËÚËıÂ› ÛÂ Ô‰ÔÓÙÈ·ÙÚÈÎ¿ ÊÔ‚ÈÛÌ¤ÓÔ˘˜ ·ÛıÂÓÂ›˜ Â›-Ó·È Ì˘ÈÎ‹ ¤ÓÙ·ÛË, ·‡ÍËÛË Ú˘ıÌÔ‡ ·Ó·ÓÔ‹˜ Î·È ‰‡-ÛÓÔÈ·, ÂÊ›‰ÚˆÛË, Ó·˘Ù›·, Ù¿ÛË ÂÌ¤ÙÔ˘, ÔÓÔÎ¤Ê·ÏÔ˜,Û‡Ó‰ÚÔÌÔ ̆ ÂÚ·ÂÚÈÛÌÔ‡, ÏÈÔı˘ÌÈÎ‹ ÚÔÛ‚ÔÏ‹2,15,16. OÈÔ‰ÔÓÙÈ·ÙÚÈÎ¿ ÊÔ‚ÈÛÌ¤ÓÔÈ ·ÛıÂÓÂ›˜ ÂÔÌ¤Óˆ˜ Î·ı˘ÛÙÂ-ÚÔ‡Ó ÙËÓ Ô‰ÔÓÙÈ·ÙÚÈÎ‹ ıÂÚ·Â›· ÌÂ ·ÔÙ¤ÏÂÛÌ· ÛËÌ·-ÓÙÈÎ¤˜ ÂÈÙÒÛÂÈ˜ ÛÙËÓ ÛÙÔÌ·ÙÈÎ‹ ˘ÁÂ›· ÙÔ˘˜ fiˆ˜ Î·È„˘¯ÔÏÔÁÈÎ¤˜ Î·È ÎÔÈÓˆÓÈÎ¤˜ Û˘Ó¤ÂÈÂ˜ Ô˘ ÂËÚÂ¿˙Ô˘Ó·ÚÓËÙÈÎ¿ ÙËÓ ÔÈfiÙËÙ· ˙ˆ‹˜ ÙÔ˘˜3,5,13,17-19.

™KO¶O™™ÎÔfi˜ ÙË˜ ÂÚÂ˘ÓËÙÈÎ‹˜ ·˘Ù‹˜ ÂÚÁ·Û›·˜ Â›Ó·È Ó· Û˘-Û¯ÂÙ›ÛÂÈ ÙÔÓ Ô‰ÔÓÙÈ·ÙÚÈÎfi Êfi‚Ô ÌÂ ÙË ÛÙÔÌ·ÙÈÎ‹ ˘ÁÂ›·Î·È ÌÂ ÔÚÈÛÌ¤Ó· ÂÈ‰ËÌÈÔÏÔÁÈÎ¿ ¯·Ú·ÎÙËÚÈÛÙÈÎ¿ fiˆ˜ÙÔ Ê‡ÏÔ, ÙËÓ ËÏÈÎ›·, ÙË ÌfiÚÊˆÛË, ÙÔÓ ÙfiÔ ‰È·ÌÔÓ‹˜ Î·ÈÓ· ·ÍÈÔÏÔÁ‹ÛÂÈ ÙË Û¯¤ÛË ÙÔ˘ ÌÂ ÙË Û˘¯ÓfiÙËÙ· Î·È ÙËÓ ·È-Ù›· ÚÔÛ¤ÏÂ˘ÛË˜ ÛÙÔÓ Ô‰ÔÓÙ›·ÙÚÔ.

Y§IKA-ME£O¢OITÔ ˘ÏÈÎfi ·ÔÙ¤ÏÂÛ·Ó 101 ·ÛıÂÓÂ›˜ (49 ¿Ó‰ÚÂ˜, 52 Á˘-Ó·›ÎÂ˜), ËÏÈÎ›·˜ 18-65 ¯ÚfiÓˆÓ Ô˘ ÚÔÛ‹Ïı·Ó ÁÈ· ÚÒ-ÙË ÊÔÚ¿ ÛÙËÓ KÏÈÓÈÎ‹ ÙË˜ ¢È·ÁÓˆÛÙÈÎ‹˜ Î·È AÎÙÈÓÔÏÔ-Á›·˜ ™ÙfiÌ·ÙÔ˜ ÙË˜ O‰ÔÓÙÈ·ÙÚÈÎ‹˜ ™¯ÔÏ‹˜ ÙÔ˘ ¶·ÓÂÈ-ÛÙËÌ›Ô˘ AıËÓÒÓ, ÛÂ ̄ ÚÔÓÈÎfi ‰È¿ÛÙËÌ· ÙÂÛÛ¿ÚˆÓ ÌËÓÒÓ(OÎÙÒ‚ÚÈÔ˜ 2008 ¤ˆ˜ I·ÓÔ˘¿ÚÈÔ˜ 2009). OÈ ·ÛıÂÓÂ›˜ÂÓËÌÂÚÒıËÎ·Ó fiÙÈ ÙËÓ ËÌ¤Ú· ÚÔÛ¤ÏÂ˘Û‹˜ ÙÔ˘˜ ‰ÂÓ ı·Á›ÓÂÈ Ô‰ÔÓÙÈ·ÙÚÈÎ‹ ıÂÚ·Â›· ·ÏÏ¿ ÌfiÓÔ ÂÍ¤Ù·ÛË Î·È ‰È¿-ÁÓˆÛË.OÈ ·ÛıÂÓÂ›˜ ÂÍÂÙ¿ÛÙËÎ·Ó ÛÙËÓ KÏÈÓÈÎ‹ ÙË˜ ¢È·ÁÓˆÛÙÈ-Î‹˜ Î·È AÎÙÈÓÔÏÔÁ›·˜ ™ÙfiÌ·ÙÔ˜ Î·È Û˘ÌÏËÚÒıËÎÂ ·ÙÔ-ÌÈÎfi˜ Ê¿ÎÂÏÔ˜ Ô˘ ÂÚÈÂÏ¿Ì‚·ÓÂ ÙË Ï‹„Ë ÈÛÙÔÚÈÎÔ‡,ÙËÓ ÎÏÈÓÈÎ‹ ÂÓ‰ÔÛÙÔÌ·ÙÈÎ‹ Î·È ÂÍˆÛÙÔÌ·ÙÈÎ‹ ÂÍ¤Ù·ÛËÎ·ıÒ˜ Î·È ÙËÓ ·ÎÙÈÓÔÁÚ·ÊÈÎ‹ ÂÍ¤Ù·ÛË. EÈ‰ÈÎfiÙÂÚ· Ë ÎÏÈ-ÓÈÎ‹ ÂÍ¤Ù·ÛË ÔÏÔÎÏËÚˆÓfiÙ·Ó ·fi ÙÂÏÂÈfiÊÔÈÙÔ ÊÔÈÙËÙ‹ÙË˜ O‰ÔÓÙÈ·ÙÚÈÎ‹˜ ™¯ÔÏ‹˜, ÂÏÂÁ¯fiÙ·Ó ·fi ‰Â‡ÙÂÚÔ ÂÍÂ-

Ù·ÛÙ‹ (ÌÂÙ·Ù˘¯È·Îfi˜ ÊÔÈÙËÙ‹˜) Î·È Ô ÙÂÏÈÎfi˜ ¤ÏÂÁ¯Ô˜ÁÈÓfiÙ·Ó ·fi ÙÚ›ÙÔ ÂÍÂÙ·ÛÙ‹ (˘Â‡ı˘ÓÔ˜ KÏÈÓÈÎ‹˜, Ì¤ÏÔ˜¢E¶). MÂ ÙÔÓ ÙÚfiÔ ·˘Ùfi ÂÍ·ÛÊ·Ï›ÛÙËÎÂ Ô ÔÈÔÙÈÎfi˜¤ÏÂÁ¯Ô˜ ÙˆÓ ·Ú·ÙËÚ‹ÛÂˆÓ Î·È ÙÔ˘ ÙÚfiÔ˘ Û˘ÏÏÔÁ‹˜ÙÔ˘˜, ÂÔÌ¤Óˆ˜ Ë Â·Ó·ÏË„ÈÌfiÙËÙ· Î·È ÂÁÎ˘ÚfiÙËÙ¿ÙÔ˘˜20. ™ÙË Û˘ÁÎÂÎÚÈÌ¤ÓË ¤ÚÂ˘Ó· ÂÎÙÈÌ‹ıËÎÂ Ô ·ÚÈıÌfi˜ÙˆÓ ÂÏÏÂÈfiÓÙˆÓ ‰ÔÓÙÈÒÓ, Ô ·ÚÈıÌfi˜ ÙˆÓ ÂÌÊÚ·¯ı¤ÓÙˆÓ‰ÔÓÙÈÒÓ, Ô ·ÚÈıÌfi˜ ÙˆÓ ÙÂÚË‰ÔÓÈÛÌ¤ÓˆÓ ‰ÔÓÙÈÒÓ3,5 Î·ÈÔ ‰Â›ÎÙË˜ DMFT21.¶ÚÔÎÂÈÌ¤ÓÔ˘ Ó· ÚÔÛ‰ÈÔÚÈÛÙÂ› ÙÔ Ì¤ÁÂıÔ˜ Î·È Ë Û˘-¯ÓfiÙËÙ· ÙÔ˘ Ô‰ÔÓÙÈ·ÙÚÈÎÔ‡ Êfi‚Ô˘ ̄ ÚËÛÈÌÔÔÈ‹ıËÎÂ ‰È-Â˘Ú˘Ì¤ÓÔ EÚˆÙËÌ·ÙÔÏfiÁÈÔ - Ì·˙› ÌÂ ÙÔ EÚˆÙËÌ·ÙÔÏfi-ÁÈÔ YÁÂ›·˜ Ô˘ ¯ÚËÛÈÌÔÔÈÂ›Ù·È ÛÙËÓ KÏÈÓÈÎ‹ ÙË˜ ¢È·-ÁÓˆÛÙÈÎ‹˜ Î·È AÎÙÈÓÔÏÔÁ›·˜ ™ÙfiÌ·ÙÔ˜ - ÚÈÓ ÙË Û˘-ÌÏ‹ÚˆÛË ÙÔ˘ Ô‰ÔÓÙÈ·ÙÚÈÎÔ‡ Ê·Î¤ÏÔ˘. TÔ EÚˆÙËÌ·-ÙÔÏfiÁÈÔ ·˘Ùfi ·ÔÙÂÏÔ‡Ù·Ó ·fi ÙÚ›· Ì¤ÚË. ™ÙÔ ÚÒÙÔÌ¤ÚÔ˜ Î·Ù·ÁÚ¿ÊÔÓÙ·Ó ÏËÚÔÊÔÚ›Â˜ Û¯ÂÙÈÎ¿ ÌÂ ÂÈ‰Ë-ÌÈÔÏÔÁÈÎ¿ ¯·Ú·ÎÙËÚÈÛÙÈÎ¿ (ËÏÈÎ›·, Ê‡ÏÔ, ÌfiÚÊˆÛË, Ùfi-Ô˜ ‰È·ÌÔÓ‹˜). TÔ ‰Â‡ÙÂÚÔ Ì¤ÚÔ˜ ·ÔÙÂÏÔ‡Û·Ó ‰‡ÔÂÚˆÙ‹ÛÂÈ˜ Û¯ÂÙÈÎ¿ ÌÂ ÙË Û˘¯ÓfiÙËÙ· Î·È ·ÈÙ›· Â›ÛÎÂ„Ë˜ÛÙÔÓ Ô‰ÔÓÙ›·ÙÚÔ.TÔ ÙÚ›ÙÔ Ì¤ÚÔ˜ ÂÚÈÂÏ¿Ì‚·ÓÂ ÂÚˆÙ‹ÛÂÈ˜ ÌÂ ‚¿ÛË ‰‡ÔÙÚÔÔÔÈËÌ¤ÓÂ˜ ÎÏ›Ì·ÎÂ˜, ÙËÓ ÙÚÔÔÔÈËÌ¤ÓË KÏ›Ì·Î·O‰ÔÓÙÈ·ÙÚÈÎÔ‡ ºfi‚Ô˘ (Dental Fear Scale - FS)22 Ë ÔÔ›·Â›Ó·È Â‡¯ÚËÛÙË Î·È ·Ï‹ Î·È ÙËÓ ÙÚÔÔÔÈËÌ¤ÓË KÏ›Ì·-Î· O‰ÔÓÙÈ·ÙÚÈÎÔ‡ ÕÁ¯Ô˘˜ (Modified Corah Dental AnxietyScale - MDAS)23 Ë ÔÔ›· Â›Ó·È ·ÍÈfiÈÛÙË Î·È ¤ÁÎ˘ÚË ÛÂ‰È¿ÊÔÚÔ˘˜ ÏËı˘ÛÌÔ‡˜3,23,24. MÂ ‚¿ÛË ÙËÓ FS, ÔÈ ·ÛıÂ-ÓÂ›˜ Î·ÏÔ‡ÓÙ·È Ó· ··ÓÙ‹ÛÔ˘Ó ÛÂ Ì›· ÌfiÓÔ ÂÚÒÙËÛË:ÓÈÒıÂÙÂ Êfi‚Ô fiÙ·Ó ËÁ·›ÓÂÙÂ ÛÙÔÓ Ô‰ÔÓÙ›·ÙÚÔ; AÓ¿ÏÔ-Á· ÌÂ ÙËÓ ·¿ÓÙËÛË, Ë KÏ›Ì·Î· O‰ÔÓÙÈ·ÙÚÈÎÔ‡ ºfi‚Ô˘,FS ÂÎÙÈÌ¿ ÙÔ Ì¤ÁÂıÔ˜ ÙÔ˘ Ô‰ÔÓÙÈ·ÙÚÈÎÔ‡ Êfi‚Ô˘ ÌÂ Ù¤Û-ÛÂÚÈ˜ ‰È·‚·ıÌ›ÛÂÈ˜: Î·ıfiÏÔ˘ Êfi‚Ô˜, ‹ÈÔ˜ Êfi‚Ô˜, Ì¤-ÙÚÈÔ˜ Êfi‚Ô˜, ˘ÂÚ‚ÔÏÈÎfi˜ Êfi‚Ô˜ Ù·ÍÈÓÔÌÒÓÙ·˜ ÙÔ˘˜·ÛıÂÓÂ›˜ ÛÂ ·ÓÙ›ÛÙÔÈ¯Â˜ Î·ÙËÁÔÚ›Â˜ (¶›Ó. 1). H KÏ›Ì·Î· O‰ÔÓÙÈ·ÙÚÈÎÔ‡ ÕÁ¯Ô˘˜, MDAS ÂÚÈÏ·Ì‚¿ÓÂÈÙ¤ÛÛÂÚÈ˜ ÂÚˆÙ‹ÛÂÈ˜. K¿ıÂ ÂÚÒÙËÛË ÂÚÈ¤¯ÂÈ 5 Èı·Ó¤˜··ÓÙ‹ÛÂÈ˜: ËÚÂÌ›· (=1), ·ÓËÛ˘¯›·(=2), ¤ÓÙ·ÛË(=3), ¿Á-¯Ô˜(=4), ˘ÂÚ‚ÔÏÈÎfi ¿Á¯Ô˜ (=5). O ·ÛıÂÓ‹˜ ıÂˆÚÂ›Ù·ÈÌË Ô‰ÔÓÙÈ·ÙÚÈÎ¿ ·Á¯ˆÌ¤ÓÔ˜ ÁÈ· MDAS ¿ıÚÔÈÛÌ· ÌÈÎÚfi-ÙÂÚÔ ÙÔ˘ 12, Ô‰ÔÓÙÈ·ÙÚÈÎ¿ ·Á¯ˆÌ¤ÓÔ˜ ÁÈ· MDAS ¿ıÚÔÈ-ÛÌ· ›ÛÔ ÌÂ 13-14 Î·È È‰È·›ÙÂÚ· ·Á¯ˆÌ¤ÓÔ˜ ÁÈ· MDAS¿ıÚÔÈÛÌ· ÌÂÁ·Ï‡ÙÂÚÔ ‹ ›ÛÔ ÙÔ˘ 15. ™ÙË Û˘ÁÎÂÎÚÈÌ¤ÓËÂÚÁ·Û›·, Ë MDAS Î·ÙËÁÔÚÈÔÔÈÂ›Ù·È ˆ˜ ÂÍ‹˜: ¿ıÚÔÈÛÌ·4 = Î·ıfiÏÔ˘ Êfi‚Ô˜, 5-8 = ‹ÈÔ˜ Êfi‚Ô˜, 9-14 = Ì¤ÙÚÈÔ˜

12


¶›Ó·Î·˜ 1

ME°E£O™ KAI ™YXNOTHTA EMºANI™H™TOY O¢ONTIATPIKOY ºOBOY

™YMºøNA ME THN K§IMAKA FS.

FS n %

Î·ıfiÏÔ˘ 41 40,59◊ÈÔ˜ 22 21,78M¤ÙÚÈÔ˜ 24 23,76YÂÚ‚ÔÏÈÎfi˜ 14 13,86

¶›Ó·Î·˜ 2

ME°E£O™ KAI ™YXNOTHTA EMºANI™H™ TOY O¢ONTIATPIKOY ºOBOY

™YMºøNA ME THN K§IMAKA MDAS.

MDAS N %K·ıfiÏÔ˘ 23 22,77◊ÈÔ˜ 44 43,56M¤ÙÚÈÔ˜ 19 18,81YÂÚ‚ÔÏÈÎfi˜ 15 14,85


Êfi‚Ô˜, 15-20 = ˘ÂÚ‚ÔÏÈÎfi˜ Êfi‚Ô˜10,17,23-27 (¶›Ó.2). EÎÙÈÌ‹ıËÎÂ Â›ÛË˜ Ë Û˘Û¯¤ÙÈÛË ÙË˜ KÏ›Ì·Î·˜O‰ÔÓÙÈ·ÙÚÈÎÔ‡ ºfi‚Ô˘, FS ÌÂ ÙËÓ KÏ›Ì·Î· O‰Ô-ÓÙÈ·ÙÚÈÎÔ‡ ÕÁ¯Ô˘˜, MDAS.H ÂÂÍÂÚÁ·Û›· ÙˆÓ ÛÙÔÈ¯Â›ˆÓ ¤ÁÈÓÂ ÌÂ ÙËÓ ̄ Ú‹ÛËSTATISTICA 8.0 ÁÈ· Windows. XÚËÛÈÌÔÔÈ‹ıËÎ·ÓÁÈ· ÙÔÓ ¤ÏÂÁ¯Ô ·ÓÂÍ·ÚÙËÛ›·˜ ÌÂÙ·Í‡ ÔÈÔÙÈÎÒÓÌÂÙ·‚ÏËÙÒÓ Ë ÛÙ·ÙÈÛÙÈÎ‹ Û˘Ó¿ÚÙËÛË X2 (Pearsonchi-square) Î·È ÁÈ· Â‡ÚÂÛË Ù˘¯Ô‡Û·˜ Û˘Û¯¤ÙÈÛË˜Ë ‰ÔÎÈÌ·Û›· ÌË ·Ú·ÌÂÙÚÈÎÔ‡ Û˘ÓÙÂÏÂÛÙ‹SpearmanR, ·ÌÊfiÙÂÚÂ˜ ÛÂ Â›Â‰Ô ÛÙ·ÙÈÛÙÈÎ‹˜ÛËÌ·ÓÙÈÎfiÙËÙ·˜ 5% (p<0,05).

A¶OTE§E™MATAH Û˘¯ÓfiÙËÙ· ÙÔ˘ ̆ ÂÚ‚ÔÏÈÎÔ‡ Ô‰ÔÓÙÈ·ÙÚÈÎÔ‡ Êfi-‚Ô˘ ÙÔ˘ ‰Â›ÁÌ·ÙÔ˜, fiˆ˜ ÂÎÙÈÌ‹ıËÎÂ ·fi ÙËÓ FSÎ·È MDAS ‹Ù·Ó 13,86% Î·È 14,85% ·ÓÙ›ÛÙÔÈ¯·. ™˘-ÓÔÏÈÎ¿ ÙÔ 33,5% ¤ˆ˜ 37,5% ÂÚ›Ô˘ ÙÔ˘ ‰Â›ÁÌ·-ÙÔ˜ ·Ó¤ÊÂÚÂ fiÙÈ ÊÔ‚fiÙ·Ó Ì¤ÙÚÈ· ˆ˜ ˘ÂÚ‚ÔÏÈÎ¿ (¶›Ó. 1Î·È 2). BÚ¤ıËÎÂ ıÂÙÈÎ‹ Û˘Ó¿ÊÂÈ· ÌÂÙ·Í‡ FS Î·È MDAS ÛÂ ‚·ı-

Ìfi ÛÙ·ÙÈÛÙÈÎ¿ ÛËÌ·ÓÙÈÎfi (Spearman R=0,84 p=0,000)(™¯. 1). OÈ Á˘Ó·›ÎÂ˜ ·Ó¤ÊÂÚ·Ó fiÙÈ ÊÔ‚Ô‡ÓÙ·Ó ÂÚÈÛÛfiÙÂÚÔ ÛÂ‚·ıÌfi ÛÙ·ÙÈÛÙÈÎ¿ ÛËÌ·ÓÙÈÎfi ÛÂ Û¯¤ÛË ÌÂ ÙÔ˘˜ ¿Ó‰ÚÂ˜

(FS: X2=11,70, p=0085,MDAS: X2=22,90, p=0,000)(™¯. 2). ¶·Ú·ÙËÚ‹ıËÎÂ ·ÚÓËÙÈÎ‹ Û˘-Ó¿ÊÂÈ· ÌÂÙ·Í‡ ÌÂÁ¤ıÔ˘˜Ô‰ÔÓÙÈ·ÙÚÈÎÔ‡ Êfi‚Ô˘ Î·È ËÏÈ-Î›·˜ Â›ÙÂ ·˘Ùfi˜ ÂÎÙÈÌ‹ıËÎÂ ÌÂÙËÓ FS ‹ ÌÂ ÙËÓ MDAS ÎÏ›-Ì·Î· (FS:Spearman R= -0,28, p=0,0050, MDAS:Spearman R=-0,29,p=0,0032), (™¯. 3 Î·È 4), ÛÂ‚·ıÌfi ÛÙ·ÙÈÛÙÈÎ¿ ÛËÌ·ÓÙÈÎfi. ¢ÂÓ ·Ú·ÙËÚ‹ıËÎÂ ÛÙ·ÙÈÛÙÈ-Î¿ ÛËÌ·ÓÙÈÎ‹ Û¯¤ÛË ÌÂÙ·Í‡ÌÂÁ¤ıÔ˘˜ Ô‰ÔÓÙÈ·ÙÚÈÎÔ‡ Êfi-‚Ô˘ - Â›ÙÂ ·˘Ùfi˜ ÂÎÙÈÌ‹ıËÎÂÌÂ ÎÏ›Ì·Î· FS ‹ MDAS - Î·ÈÌfiÚÊˆÛË˜ (FS: X2=5,09,df=6, p=0,53, MDAS: X2

=9,18, df=6, p=0,16) Î·ıÒ˜Î·È ÙfiÔ˘ ‰È·ÌÔÓ‹˜ (FS:X2=4,22, df=3, p=0,23,MDAS: X2=3,72, df=3,p=0,29 ). ¢ÂÓ ·Ú·ÙËÚ‹ıËÎÂÂ›ÛË˜ ÛÙ·ÙÈÛÙÈÎ¿ ÛËÌ·ÓÙÈÎ‹Û¯¤ÛË ÌÂÙ·Í‡ Ô‰ÔÓÙÈ·ÙÚÈÎÔ‡Êfi‚Ô˘ - Â›ÙÂ ·˘Ùfi˜ ÂÎÙÈÌ‹ıË-ÎÂ ÌÂ ÎÏ›Ì·Î· FS ‹ MDAS -Î·È Û˘¯ÓfiÙËÙ·˜ (FS: X2=5,36,df=6, p=0,49, MDAS: X2

=4,51, df=6, p=0,60) Î·È ·È-Ù›·˜ ÚÔÛ¤ÏÂ˘ÛË˜ ÛÙÔÓ Ô‰Ô-ÓÙ›·ÙÚÔ (FS: X2=7,13, df=6,p=0,30, MDAS: X2=2,32,df=6, p=0,88)

13



™¯‹Ì· 2. ™XE™H O¢ONTIATPIKOY ºOBOY KAI ºY§OY

™¯‹Ì· 1.

£ETIKH ™YNAºEIA META•Y TøN ¢YO K§IMAKøN FS KAI MDAS™THN A•IO§O°H™H TOY ME°E£OY™ KAI ™YXNOTHTA™ TOY O¢ONTIATPIKOY ºOBOY

™¯‹Ì· 3.

APNHTIKH ™YNAºEIA META•Y ME°E£OY™ O¢ONTIATPIKOY ºOBOYKAI H§IKIA™ ™YMºøNA ME THN K§IMAKA FS

MDAS

FS

FS

ËÏÈÎ›·

60,00%

50,00%

40,00%

30,00%

20,00%

10,00%

0,00%K·ıfiÏÔ˘ HÈÔ M¤ÙÚÈÔ YÂÚ‚ÔÏÈÎfi

MDASK·ıfiÏÔ˘ HÈÔ M¤ÙÚÈÔ YÂÚ‚ÔÏÈÎfi

FS

ıËÏ˘AÚÚÂÓ

¶·Ú·ÙËÚ‹ıËÎÂ ıÂÙÈÎ‹ Û˘Ó¿ÊÂÈ· ÌÂÙ·Í‡ ÌÂÁ¤ıÔ˘˜ Ô‰Ô-ÓÙÈ·ÙÚÈÎÔ‡ Êfi‚Ô˘, fiÙ·Ó ·˘Ùfi˜ ÂÎÙÈÌ‹ıËÎÂ ÌÂ ÙËÓ ÎÏ›-Ì·Î· FS, Î·È ·ÚÈıÌÔ‡ ÂÏÏÂÈfiÓÙˆÓ ‰ÔÓÙÈÒÓ ÛÂ ‚·ıÌfiÛÙ·ÙÈÛÙÈÎ¿ ÛËÌ·ÓÙÈÎfi Î·È ·ÚÓËÙÈÎ‹ Û˘Ó¿ÊÂÈ· ÌÂÙ·Í‡ ÙÔ˘ÚÒÙÔ˘ Î·È ÙÔ˘ ·ÚÈıÌÔ‡ ÙˆÓ ÂÌÊÚ·¯ı¤ÓÙˆÓ ‰ÔÓÙÈÒÓÂ›ÛË˜ ÛÂ ‚·ıÌfi ÛÙ·ÙÈÛÙÈÎ¿ ÛËÌ·ÓÙÈÎfi. ¢ÂÓ ‚Ú¤ıËÎÂÛ˘Û¯¤ÙÈÛË ÛÂ Â›Â‰Ô ÛÙ·ÙÈÛÙÈÎ‹˜ ÛËÌ·ÓÙÈÎfiÙËÙ·˜ 5%ÌÂÙ·Í‡ FS Î·È DMFT (¶›Ó. 3). ŸÙ·Ó Ô Ô‰ÔÓÙÈ·ÙÚÈÎfi˜ Êfi‚Ô˜ ÂÎÙÈÌ‹ıËÎÂ ÌÂ ÙËÓ MDAS˘‹Ú¯Â ÔÚÈ·Î¿ ıÂÙÈÎ‹ Û˘Ó¿ÊÂÈ· ÌÂÙ·Í‡ ·˘ÙÔ‡ Î·È ·ÚÈı-ÌÔ‡ ÙÂÚË‰ÔÓÈÛÌ¤ÓˆÓ ‰ÔÓÙÈÒÓ ÛÂ ‚·ıÌfi ÛÙ·ÙÈÛÙÈÎ¿ ÛË-Ì·ÓÙÈÎfi Î·È ·ÚÓËÙÈÎ‹ Û˘Ó¿ÊÂÈ· ÌÂ ÙÔÓ ·ÚÈıÌfi ÙˆÓ ÂÌ-ÊÚ·¯ı¤ÓÙˆÓ ‰ÔÓÙÈÒÓ ÛÂ ‚·ıÌfi Â›ÛË˜ ÛÙ·ÙÈÛÙÈÎ¿ ÛË-Ì·ÓÙÈÎfi. ¢ÂÓ ˘‹Ú¯Â Û˘Ó¿ÊÂÈ· ÛÂ Â›Â‰Ô ÛÙ·ÙÈÛÙÈÎ¿ÛËÌ·ÓÙÈÎfi ÌÂÙ·Í‡ MDAS Î·È DMFT (¶›Ó. 4).

™YZHTH™H ™ÙËÓ ÂÚÁ·Û›· ·˘Ù‹ ¯ÚËÛÈÌÔ-ÔÈ‹ıËÎ·Ó ‰‡Ô ‰È·ÊÔÚÂÙÈÎ¿Ì¤ÙÚ· ÂÎÙ›ÌËÛË˜ ÙÔ˘ Ô‰Ô-ÓÙÈ·ÙÚÈÎÔ‡ Êfi‚Ô˘ ÁÈ· ÙÔ ›‰ÈÔ‰Â›ÁÌ· ·ÛıÂÓÒÓ Î·È ÚÔ¤Î˘-„·Ó ‰È·ÊÔÚÂÙÈÎ¿ ·ÔÙÂÏ¤-ÛÌ·Ù·, Â‡ÚËÌ· Ô˘ Û˘ÌÊˆ-ÓÂ› Î·È ÌÂ ¿ÏÏÂ˜ ¤ÚÂ˘ÓÂ˜4,24-27.™˘ÁÎÂÎÚÈÌ¤Ó·, ÔÈ Locker Î·ÈÛ˘Ó26 ˘ÔÛÙËÚ›˙Ô˘Ó fiÙÈ ·˘ÙfiÛ˘Ì‚·›ÓÂÈ ÁÈ·Ù› Î¿ıÂ Ì¤ÙÚÔ¯ÚËÛÈÌÔÔÈÂ› ‰È·ÊÔÚÂÙÈÎ¿fiÚÈ· (cut - off points) ÚÔÎÂÈ-Ì¤ÓÔ˘ Ó· ‰È·ÎÚ›ÓÂÈ ·˘ÙÔ‡˜Ô˘ Â›Ó·È Ô‰ÔÓÙÈ·ÙÚÈÎ¿ ÊÔ‚È-ÛÌ¤ÓÔÈ. H ÎÏ›Ì·Î· FS, ıÂˆ-ÚÔ‡Ó ÔÈ ›‰ÈÔÈ, fiÙÈ ̄ ÚËÛÈÌÔÔÈÂ›

ÈÔ ·˘ÛÙËÚ¿ fiÚÈ· ÚÔÎÂÈÌ¤ÓÔ˘ Ó· Û˘ÌÂÚÈÏ¿‚ÂÈ ÌfiÓÔÛÔ‚·Ú¤˜ ÂÚÈÙÒÛÂÈ˜. E›ÛË˜ ÛËÌ·ÓÙÈÎfi˜ Ê·›ÓÂÙ·È Ó·Â›Ó·È Ô ÚfiÏÔ˜ ÙÔ˘ Â›‰Ô˘˜ ÙˆÓ ÂÚˆÙ‹ÛÂˆÓ Ô˘ Û˘Óı¤ÙÔ˘ÓÎ¿ıÂ Ì¤ÙÚÔ ÂÎÙ›ÌËÛË˜ ÙÔ˘ Ô‰ÔÓÙÈ·ÙÚÈÎÔ‡ Êfi‚Ô˘ Î·È Û˘-ÁÎÂÎÚÈÌ¤Ó· ·Ó ·˘Ù¤˜ ‰›ÓÔ˘Ó ¤ÌÊ·ÛË ÛÙË Û˘Ó·ÈÛıËÌ·ÙÈ-Î‹ ·ÓÙ›‰Ú·ÛË ÙÔ˘ ·ÛıÂÓÔ‡˜ ÛÂ ¤Ó· Ô‰ÔÓÙÈ·ÙÚÈÎfi ÂÚ¤ıÈ-ÛÌ· ‹ ÛÙÔÓ ÙÚfiÔ Ô˘ Û˘ÌÂÚÈÊ¤ÚÂÙ·È. ŒÙÛÈ ÔÈ LindayÎ·È Jackson28 ˘ÔÛÙËÚ›˙Ô˘Ó fiÙÈ Ë DAS ÎÏ›Ì·Î· ‰˘Ó·ÙfiÓÓ· ̆ ÔÙÈÌ‹ÛÂÈ ÙÔ Ì¤ÁÂıÔ˜ ÙÔ˘ Ô‰ÔÓÙÈ·ÙÚÈÎÔ‡ Êfi‚Ô˘ ·Ùfi-ÌˆÓ Ô˘ ‰ÂÓ ‰ËÏÒÓÔ˘Ó Û˘Ó·ÈÛıËÌ·ÙÈÎ‹ ·ÓÙ›‰Ú·ÛË ÛÂÛ¯¤ÛË ÌÂ ÙËÓ Ô‰ÔÓÙÈ·ÙÚÈÎ‹ ıÂÚ·Â›·. OÈ Milgrom Î·È Û˘Ó2

ıÂˆÚÔ‡Ó fiÙÈ fiÛÔÈ ‰ËÏÒÓÔ˘Ó fiÙÈ ÊÔ‚Ô‡ÓÙ·È Ì¤ÙÚÈ· ÙËÓÔ‰ÔÓÙÈ·ÙÚÈÎ‹ ıÂÚ·Â›· ı· Ú¤ÂÈ Ó· Û˘ÌÂÚÈÏ·Ì‚¿ÓÔ-ÓÙ·È ÛÙËÓ ÔÌ¿‰· ÙˆÓ ˘ÂÚ‚ÔÏÈÎ¿ Ô‰ÔÓÙÈ·ÙÚÈÎ¿ ÊÔ‚È-ÛÌ¤ÓˆÓ, ·ÊÔ‡ Ë ÎÏÈÓÈÎ‹ ÂÌÂÈÚ›· ‰Â›¯ÓÂÈ fiÙÈ Ë Û˘ÌÂÚÈ-

ÊÔÚ¿ ÙˆÓ ÚÒÙˆÓ ÂÚÈÏ·Ì-‚¿ÓÂÈ ÙËÓ ·Ó·‚ÔÏ‹ Ô‰ÔÓÙÈ·-ÙÚÈÎÒÓ ÂÈÛÎ¤„ÂˆÓ ¤ˆ˜ Î·È·ÔÊ˘Á‹ ÙË˜ Ô‰ÔÓÙÈ·ÙÚÈÎ‹˜ıÂÚ·Â›·˜.OÈ Hakeberg Î·È Û˘Ó27 ÛÂ¤ÚÂ˘Ó¿ ÙÔ˘˜ Ô˘ ¯ÚËÛÈÌÔ-Ô›ËÛ·Ó 2 ‰È·ÊÔÚÂÙÈÎ¿ Ì¤ÙÚ·(DAS Î·È FS) ·Ó·Ê¤ÚÔ˘Ó fiÙÈÔ ÂÈÔÏ·ÛÌfi˜ ÙÔ˘ ˘ÂÚ‚Ô-ÏÈÎÔ‡ Ô‰ÔÓÙÈ·ÙÚÈÎÔ‡ Êfi‚Ô˘ÛÙÔ ‰Â›ÁÌ· ÙÔ˘˜ ‹Ù·Ó 5,4%Î·È 6,7%, ·ÓÙ›ÛÙÔÈ¯·. OVassend25 ¯ÚËÛÈÌÔÔÈÒÓÙ·˜Â›ÛË˜ Ù· ›‰È· Ì¤ÙÚ· ·Ó·Ê¤-ÚÔ˘Ó ÂÈÔÏ·ÛÌfi 4,2% Î·È7,1% ·ÓÙ›ÛÙÔÈ¯·, ÂÓÒ ÔÈLocker Î·È Û˘Ó26 ·Ó·Ê¤ÚÔ˘ÓÂÈÔÏ·ÛÌfi 10,9% Î·È 8,2%·ÓÙ›ÛÙÔÈ¯·. OÈ ›‰ÈÔÈ ÚÔÙÂ›-ÓÔ˘Ó25,26, fiˆ˜ Î·È ¿ÏÏÔÈ24,29, fiÙÈÏfiÁˆ ·Ô˘Û›·˜ È‰·ÓÈÎÔ‡ Ì¤-ÙÚÔ˘ ÁÈ· ÙÔÓ Ô‰ÔÓÙÈ·ÙÚÈÎfiÊfi‚Ô (gold standard) Î·Ïfi Â›-Ó·È Ó· ̄ ÚËÛÈÌÔÔÈÔ‡ÓÙ·È ‰˘Ô

14


™¯‹Ì· 4.

APNHTIKH ™YNAºEIA META•Y ME°E£OY™ O¢ONTIATPIKOY ºOBOYKAI H§IKIA™ ™YMºøNA ME THN K§IMAKA MDAS

¶›Ó·Î·˜ 3

™Y™XETI™H O¢ONTIATPIKOY ºOBOY ME ™TOMATIKH Y°EIA ™YMºøNA ME K§IMAKA FS.

O¢ONTIKH KATA™TA™H KAI FS Valid-N Spearman- R P

ÙÂÚË‰ÔÓÈÛÌ¤Ó· ‰fiÓÙÈ· 101 0,19 0,06ÂÏÏÂ›ÔÓÙ· ‰fiÓÙÈ· 101 0,21 0,04ÂÌÊÚ·¯ı¤ÓÙ· ‰fiÓÙÈ· 101 -0,22 0,03DMFT 101 0,09 0,35

¶›Ó·Î·˜ 4

™Y™XETI™H O¢ONTIATPIKOY ºOBOY ME ™TOMATIKH Y°EIA™YMºøNA ME K§IMAKA MDAS.

O¢ONTIKH KATA™TA™H KAI MDAS Valid-N Spearman- R p

ÙÂÚË‰ÔÓÈÛÌ¤Ó· ‰fiÓÙÈ· 101 0,19 0,05ÂÏÏÂ›ÔÓÙ· ‰fiÓÙÈ· 101 0,17 0,09ÂÌÊÚ·¯ı¤ÓÙ· ‰fiÓÙÈ· 101 -0,23 0,02DMFT 101 0,08 0,41


ËÏÈÎ›·

MDAS

Ì¤ÙÚ· ÂÎÙ›ÌËÛË˜ ÙÔ˘ Ô‰ÔÓÙÈ·ÙÚÈÎÔ‡ Êfi‚Ô˘ ÚÔÎÂÈÌ¤ÓÔ˘Ó· ÌÂÏÂÙ¿Ù·È Ô ‚·ıÌfi˜ Û˘Û¯¤ÙÈÛ‹˜ ÙÔ˘˜ ·ÏÏ¿ Î·È Ó· ÂÎÙÈ-Ì¿Ù·È ÙÔ Ì¤ÁÂıÔ˜ Î·È Ë Û˘¯ÓfiÙËÙ· ÙÔ˘ Êfi‚Ô˘ ÌÂ Û˘ÓÔ-ÏÈÎfi ÙÚfiÔ.H ¯Ú‹ÛË ‰È·ÊÔÚÂÙÈÎÒÓ Ì¤ÙÚˆÓ ÂÎÙ›ÌËÛË˜ ÙÔ˘ Ô‰ÔÓÙÈ·-ÙÚÈÎÔ‡ Êfi‚Ô˘ ÛÙÈ˜ ‰È¿ÊÔÚÂ˜ ÂÚÂ˘ÓËÙÈÎ¤˜ ÂÚÁ·Û›Â˜, Ë‰È·ÊÔÚÂÙÈÎ‹ ÌÂıÔ‰ÔÏÔÁ›· ÂÈÏÔÁ‹˜ ÙÔ˘ ‰Â›ÁÌ·ÙÔ˜ Î¿-ÓÔ˘Ó ‰‡ÛÎÔÏË ÙË Û‡ÁÎÚÈÛË ÙˆÓ ·ÔÙÂÏÂÛÌ¿ÙˆÓ ·˘Ù‹˜ÙË˜ ¤ÚÂ˘Ó·˜ ÌÂ ·˘Ù¤˜ ¿ÏÏˆÓ ̄ ˆÚÒÓ26,27,30,31. EÈ‰ÈÎfiÙÂÚ· ÔÂÈÔÏ·ÛÌfi˜ ÙÔ˘ ̆ ÂÚ‚ÔÏÈÎÔ‡ Ô‰ÔÓÙÈ·ÙÚÈÎÔ‡ Êfi‚Ô˘ ¤¯ÂÈÂÎÙÈÌËıÂ› ÛÂ ‰È¿ÊÔÚÂ˜ ¯ÒÚÂ˜ Î·È ‰Â›¯ÓÂÈ Ó· Î˘Ì·›ÓÂÙ·È·fi 4,2%32 ¤ˆ˜ 20,9%33. EÈÏ¤ÔÓ ÙÔ ‰Â›ÁÌ· ÙË˜ ÂÚÁ·-Û›·˜ ·˘Ù‹˜ ‰ÂÓ ıÂˆÚÂ›Ù·È ·ÓÙÈÚÔÛˆÂ˘ÙÈÎfi ÙÔ˘ ÁÂÓÈ-ÎÔ‡ ÏËı˘ÛÌÔ‡ ÁÈ·Ù› ·ÊÔÚ¿ ·ÛıÂÓÂ›˜ ÙË˜ O‰ÔÓÙÈ·ÙÚÈ-Î‹˜ ™¯ÔÏ‹˜. ¶·Ú¿ ÙÔ˘˜ ÂÚÈÔÚÈÛÌÔ‡˜ Ô˘ ·Ó·Ê¤ÚıË-Î·Ó, Ë Û˘¯ÓfiÙËÙ· ÙÔ˘ ˘ÂÚ‚ÔÏÈÎÔ‡ Ô‰ÔÓÙÈ·ÙÚÈÎÔ‡ Êfi-‚Ô˘ ÙË˜ Û˘ÁÎÂÎÚÈÌ¤ÓË˜ ¤ÚÂ˘Ó·˜ (13,86% - 14,85%) Î˘-Ì·›ÓÂÙ·È ÛÙ· fiÚÈ· Ô˘ ·Ó·Ê¤ÚÔÓÙ·È ‰ÈÂıÓÒ˜ (4,2% - 20,9%)Î·È Ê·›ÓÂÙ·È ˘„ËÏ‹. T· ·ÔÙÂÏ¤ÛÌ·Ù· ÙË˜ ¤ÚÂ˘Ó·˜ ¤‰ÂÈÍ·Ó fiÙÈ ÔÈ Á˘Ó·›ÎÂ˜·Ó·Ê¤ÚÔ˘Ó fiÙÈ ÊÔ‚Ô‡ÓÙ·È ÂÚÈÛÛfiÙÂÚÔ ÛÂ Û¯¤ÛË ÌÂ ÙÔ˘˜¿Ó‰ÚÂ˜, Â‡ÚËÌ· Ô˘ Ê·›ÓÂÙ·È Ó· Û˘ÌÊˆÓÂ› ÌÂ ÙËÓ ÏÂÈ-Ô„ËÊ›· ‰ËÌÔÛÈÂ˘Ì¤ÓˆÓ ÂÚÂ˘ÓÒÓ2,3,24,27,31,34. OÈ Coolidge Î·ÈÛ˘Ó24 ıÂˆÚÔ‡Ó fiÙÈ Ù· ·ÔÙÂÏ¤ÛÌ·Ù· ÙË˜ ‰ÈÎ‹˜ ÙÔ˘˜ ¤ÚÂ˘-Ó·˜ ̆ Ô‰ÂÈÎÓ‡Ô˘Ó fiÙÈ ÔÈ Ô‰ÔÓÙ›·ÙÚÔÈ Ô˘ ¤¯Ô˘Ó ·ÛıÂÓÂ›˜ŒÏÏËÓÂ˜ ı· Ú¤ÂÈ Ó· ÂÚÈÌ¤ÓÔ˘Ó fiÙÈ ÔÈ Á˘Ó·›ÎÂ˜ ¤¯Ô˘ÓÂÓÙÔÓfiÙÂÚÔ Ô‰ÔÓÙÈ·ÙÚÈÎfi Êfi‚Ô ÛÂ Û¯¤ÛË ÌÂ ÙÔ˘˜ ¿Ó-‰ÚÂ˜. A˘Ùfi Èı·ÓÒ˜ ÔÊÂ›ÏÂÙ·È ÛÙÔ fiÙÈ ÔÈ EÏÏËÓ›‰Â˜ Á˘-Ó·›ÎÂ˜ Â›Ó·È ÁÂÓÈÎfiÙÂÚ· ÂÚÈÛÛfiÙÂÚÔ ·Á¯ˆÌ¤ÓÂ˜ ÛÂ Û¯¤-ÛË ÌÂ ÙÔ˘˜ ŒÏÏËÓÂ˜ ¿Ó‰ÚÂ˜. ÕÏÏÔÈ ÂÚÂ˘ÓËÙ¤˜ ·Ó·Ê¤-ÚÔ˘Ó fiÙÈ ‰ÂÓ ˘¿Ú¯ÂÈ ‰È·ÊÔÚ¿ ·Ó¿ÌÂÛ· ÛÙ· ‰‡Ô Ê‡Ï·ÛÂ Û¯¤ÛË ÌÂ ÙÔÓ Ô‰ÔÓÙÈ·ÙÚÈÎfi Êfi‚Ô11. ŸÛÔÓ ·ÊÔÚ¿ ÙËÓ ËÏÈÎ›· Ê·›ÓÂÙ·È fiÙÈ fiÛÔ ·˘Í¿ÓÂÙ·È, ÌÂÈ-ÒÓÂÙ·È ÙÔ Ì¤ÁÂıÔ˜ ÙÔ˘ Ô‰ÔÓÙÈ·ÙÚÈÎÔ‡ Êfi‚Ô˘ Î·È ·ÓÙ›-ÛÙÚÔÊ·. AÚÎÂÙÔ› ÂÚÂ˘ÓËÙ¤˜ Ê·›ÓÂÙ·È Ó· Û˘ÌÊˆÓÔ‡Ó fiÙÈ¿ÙÔÌ· ÓÂ·Ú‹˜ ËÏÈÎ›·˜ (18 ¤ˆ˜ 30 ¯ÚfiÓˆÓ ÂÚ›Ô˘) ·Ó·-Ê¤ÚÔ˘Ó ̆ ÂÚ‚ÔÏÈÎfi Ô‰ÔÓÙÈ·ÙÚÈÎfi Êfi‚Ô ÛÂ Û¯¤ÛË ÌÂ ÈÔËÏÈÎÈˆÌ¤Ó· ¿ÙÔÌ· (¿Óˆ ÙˆÓ 50 ¯ÚfiÓˆÓ)2,11,13,27,31. H Û¯¤ÛË·˘Ù‹ Èı·ÓÒ˜ ÂÚÌËÓÂ‡ÂÙ·È ÌÂ ÙËÓ Â›‰Ú·ÛË ÙË˜ ËÏÈÎ›·˜(age effect) ‹ ÌÂ ÙËÓ Â›‰Ú·ÛË ÁÂÓÈ¿˜ (cohort effect) ‹ ÌÂÙË Û˘Ó‰˘·ÛÌ¤ÓË Â›‰Ú·ÛË Î·È ÙˆÓ ‰‡Ô11,35. ™˘ÁÎÂÎÚÈÌ¤-Ó· ·Ó Ë ·‡ÍËÛË ÙË˜ ËÏÈÎ›·˜ ÌÂÈÒÓÂÈ ÙÔÓ Ô‰ÔÓÙÈ·ÙÚÈÎfi Êfi-‚Ô ·˘Ùfi Èı·ÓÒ˜ ÔÊÂ›ÏÂÙ·È ÛÙÔ fiÙÈ ÌÂ Ù· ¯ÚfiÓÈ· ˘¿Ú-¯ÂÈ Û˘¯ÓfiÙÂÚË Î·È Û˘ÓÂ¯‹˜ ¤ÎıÂÛË ÛÂ Ô‰ÔÓÙÈ·ÙÚÈÎ¿ ÂÚÂ-ı›ÛÌ·Ù· Î·È ÂÔÌ¤Óˆ˜ ÌÂÁ·Ï‡ÙÂÚË ·ÓÔ¯‹ ÛÙËÓ Ô‰ÔÓÙÈ·-ÙÚÈÎ‹ ıÂÚ·Â›·36.ÕÏÏ· ÂÈ‰ËÌÈÔÏÔÁÈÎ¿ ¯·Ú·ÎÙËÚÈÛÙÈÎ¿ fiˆ˜ Ë ÌfiÚÊˆÛË‰ÂÓ Û˘Û¯ÂÙ›ÛÙËÎÂ ÌÂ ÙÔÓ Ô‰ÔÓÙÈ·ÙÚÈÎfi Êfi‚Ô. A˘Ùfi Û˘Ì-ÊˆÓÂ› ÌÂ Ù· Â˘Ú‹Ì·Ù· ÙˆÓ MilgrÔm Î·È Û˘Ó2 StouthardÎ·È Û˘Ó37, Locker Î·È Û˘Ó11, Hakeberg Î·È Û˘Ó27, ChanpongÎ·È Û˘Ó4. øÛÙfiÛÔ Ù· Â˘Ú‹Ì·Ù· ¿ÏÏˆÓ ÂÚÂ˘ÓÒÓ ‰Â›¯ÓÔ˘ÓfiÙÈ Ô ˘ÂÚ‚ÔÏÈÎfi˜ Ô‰ÔÓÙÈ·ÙÚÈÎfi˜ Êfi‚Ô˜ Û¯ÂÙ›˙ÂÙ·È ÌÂ¯·ÌËÏ‹ ÌfiÚÊˆÛË3,32.™ÙËÓ ¤ÚÂ˘Ó· ·˘Ù‹ ‰ÂÓ ·Ú·ÙËÚ‹ıËÎÂ Â›ÛË˜ Û¯¤ÛË ÌÂ-Ù·Í‡ ÙfiÔ˘ ‰È·ÌÔÓ‹˜ Î·È Ô‰ÔÓÙÈ·ÙÚÈÎÔ‡ Êfi‚Ô˘. AÓ Î·È‰ÂÓ Ê·›ÓÂÙ·È Ó· ˘¿Ú¯Ô˘Ó ·ÚÎÂÙ¤˜ ¤ÚÂ˘ÓÂ˜ ÛÙË ‰ÈÂıÓ‹‚È‚ÏÈÔÁÚ·Ê›· Ô˘ Ó· Û˘ÁÎÚ›ÓÔ˘Ó ÙÔ Ì¤ÁÂıÔ˜ ÙÔ˘ Ô‰Ô-ÓÙÈ·ÙÚÈÎÔ‡ Êfi‚Ô˘ ÛÂ ¿ÙÔÌ· Ô˘ ˙Ô˘Ó ÛÙËÓ ÚˆÙÂ‡Ô˘Û·

ÌÂ ·˘Ù¿ Ô˘ ˙Ô˘Ó ÛÙËÓ Â·Ú¯›·, ÔÈ Nicolas Î·È Û˘Ó13 ÛÂ¤ÚÂ˘Ó¿ ÙÔ˘˜ ·Ó·Ê¤ÚÔ˘Ó fiÙÈ ÙÔ Ô‰ÔÓÙÈ·ÙÚÈÎfi ¿Á¯Ô˜ ‹Ù·ÓÌÂÁ·Ï‡ÙÂÚÔ ÁÈ· Ù· ¿ÙÔÌ· Ô˘ ̇ Ô˘Ó ÛÙË Á·ÏÏÈÎ‹ Â·Ú¯›·ÛÂ Û¯¤ÛË ÌÂ ·˘Ù¿ Ô˘ ˙Ô˘Ó ÛÙÈ˜ Á·ÏÏÈÎ¤˜ fiÏÂÈ˜. MÂÁ¿ÏÔ˜ ·ÚÈıÌfi˜ ÂÚÂ˘ÓËÙÒÓ ˘ÔÛÙËÚ›˙Ô˘Ó fiÙÈ Ô Ô‰Ô-ÓÙÈ·ÙÚÈÎfi˜ Êfi‚Ô˜ ‰˘Ó·ÙfiÓ Ó· ÚÔÎ·Ï¤ÛÂÈ Î·ı˘ÛÙ¤ÚËÛËÙË˜ Ô‰ÔÓÙÈ·ÙÚÈÎ‹˜ ıÂÚ·Â›·˜ ‰ËÌÈÔ˘ÚÁÒÓÙ·˜ ¤ÙÛÈ ¤Ó·Ê·‡ÏÔ Î‡ÎÏÔ2,4,5,10,13,24. ™ÙË Û˘ÁÎÂÎÚÈÌ¤ÓË ¤ÚÂ˘Ó· ‰Â ‚Ú¤-ıËÎÂ ÛÙ·ÙÈÛÙÈÎ¿ ÛËÌ·ÓÙÈÎ‹ Û¯¤ÛË ÌÂÙ·Í‡ Ô‰ÔÓÙÈ·ÙÚÈÎÔ‡Êfi‚Ô˘ Î·È ÙË˜ Û˘¯ÓfiÙËÙ·˜ Î·È ·ÈÙ›·˜ ÚÔÛ¤ÏÂ˘ÛË˜ ÛÙÔÓÔ‰ÔÓÙ›·ÙÚÔ. EÓ‰È·Ê¤ÚÔÓ fiÌˆ˜ Â›Ó·È fiÙÈ ÙÔ 80% ÂÚ›Ô˘ÙÔ˘ ‰Â›ÁÌ·ÙÔ˜, ÙË˜ ¤ÚÂ˘Ó·˜ ·˘Ù‹˜, Ô˘ ‰‹ÏˆÓÂ fiÙÈ ‰ÂÓÊÔ‚¿Ù·È Î·ıfiÏÔ˘ (MDAS) Î·È ÙÔ 75% ÂÚ›Ô˘ ÙÔ˘ ‰Â›Á-Ì·ÙÔ˜ Ô˘ ‰‹ÏˆÓÂ fiÙÈ Â›ÛË˜ ‰ÂÓ ÊÔ‚¿Ù·È Î·ıfiÏÔ˘ (FS)ÂÈÛÎ¤ÙÂÙ·È ÙÔÓ Ô‰ÔÓÙ›·ÙÚÔ ÌfiÓÔ fiÙ·Ó ˘¿Ú¯ÂÈ Úfi-‚ÏËÌ· Î·È Û˘ÁÎÂÎÚÈÌ¤Ó· ÁÈ· ·ÓÙÈÌÂÙÒÈÛË fiÓÔ˘, ˘Ô-‰ÂÈÎÓ‡ÔÓÙ·˜ fiÙÈ Èı·ÓÒ˜ ˘¿Ú¯Ô˘Ó Î·È ¿ÏÏÔÈ ·Ú¿ÁÔ-ÓÙÂ˜ Ô˘ ÂËÚÂ¿˙Ô˘Ó ÙË Û˘¯ÓfiÙËÙ· Î·È ·ÈÙ›· Ô‰ÔÓÙÈ·-ÙÚÈÎ‹˜ Â›ÛÎÂ„Ë˜, ÂÎÙfi˜ ÙÔ˘ Ô‰ÔÓÙÈ·ÙÚÈÎÔ‡ Êfi‚Ô˘. ¶Ú¿Á-Ì·ÙÈ ÂÚÂ˘ÓËÙ¤˜ ¤¯Ô˘Ó ‰Â›ÍÂÈ fiÙÈ Ë Û˘¯ÓfiÙËÙ· Â›ÛÎÂ„Ë˜ÛÙÔÓ Ô‰ÔÓÙ›·ÙÚÔ ÂÔÌ¤Óˆ˜ Î·È Ë ˙‹ÙËÛË Ô‰ÔÓÙÈ·ÙÚÈÎ‹˜ÂÚ›ı·Ï„Ë˜ ‰˘Ó·ÙfiÓ ÂËÚÂ·ÛÙÂ› ·fi ÙÔ ÔÈÎÔÓÔÌÈÎfi Îfi-ÛÙÔ˜ ÙË˜ ıÂÚ·Â›·˜5, ·fi ¤ÏÏÂÈ„Ë ¯ÚfiÓÔ˘38 ‹ ·fi ·¿-ıÂÈ· Î·È ¤ÏÏÂÈ„Ë ÂÓ‰È·Ê¤ÚÔÓÙÔ˜ ÁÈ· ı¤Ì·Ù· ÛÙÔÌ·ÙÈÎ‹˜˘ÁÂ›·˜39.O Ô‰ÔÓÙÈ·ÙÚÈÎfi˜ Êfi‚Ô˜ Ê·›ÓÂÙ·È Ó· ¤¯ÂÈ ÂÈÙÒÛÂÈ˜ ÛÙËÛÙÔÌ·ÙÈÎ‹ ˘ÁÂ›· ÙˆÓ ·ÛıÂÓÒÓ. H ‰È·›ÛÙˆÛË ·˘Ù‹ ÌÔ-ÚÂ› Ó· ·Ô‰ÔıÂ› ÛÙÔ fiÙÈ Ù· ·ÔÙÂÏ¤ÛÌ·Ù· ÙË˜ ¤ÚÂ˘Ó·˜·˘Ù‹˜ ¤‰ÂÈÍ·Ó fiÙÈ fiÛÔ ÌÂÁ·Ï‡ÙÂÚÔ˜ Â›Ó·È Ô Ô‰ÔÓÙÈ·ÙÚÈ-Îfi˜ Êfi‚Ô˜ ÙˆÓ ·ÛıÂÓÒÓ ÙfiÛÔ ÌÂÁ·Ï‡ÙÂÚÔ˜ Â›Ó·È Ô ·ÚÈı-Ìfi˜ ÙˆÓ ÂÏÏÂÈfiÓÙˆÓ ‰ÔÓÙÈÒÓ, ·ÏÏ¿ Î·È Ô ·ÚÈıÌfi˜ ÙˆÓÙÂÚË‰ÔÓÈÛÌ¤ÓˆÓ ‰ÔÓÙÈÒÓ, ÂÓÒ fiÛÔ ÌÈÎÚfiÙÂÚÔ˜ Ô Ô‰Ô-ÓÙÈ·ÙÚÈÎfi˜ Êfi‚Ô˜ ÙfiÛÔ ÌÂÁ·Ï‡ÙÂÚÔ˜ Ô ·ÚÈıÌfi˜ ÙˆÓ ÂÌ-ÊÚ·¯ı¤ÓÙˆÓ ‰ÔÓÙÈÒÓ. OÈ Milgrom Î·È Û˘Ó2 Ê·›ÓÂÙ·È Ó·Û˘ÌÊˆÓÔ‡Ó fiÙÈ Ù· ¿ÙÔÌ· Ô˘ ÊÔ‚Ô‡ÓÙ·È ÂÚÈÛÛfiÙÂÚÔ¤¯Ô˘Ó ÌÂÚÈÎ‹ ·ÒÏÂÈ· ‰ÔÓÙÈÒÓ ‹ ÔÏÈÎ‹ ÛÙË Ì›· ‹ Î·È ÛÙÈ˜‰‡Ô ÁÓ¿ıÔ˘˜, fiˆ˜ Î·È ÔÈ Locker Î·È Lidell7 Ô˘ ·Ó·Ê¤-ÚÔ˘Ó fiÙÈ Ù· Ô‰ÔÓÙÈ·ÙÚÈÎ¿ ÊÔ‚ÈÛÌ¤Ó· ¿ÙÔÌ· ÙÔ˘ ‰Â›ÁÌ·-ÙÔ˜ ÛÙËÓ ¤ÚÂ˘Ó¿ ÙÔ˘˜ Â›¯·Ó ÂÚÈÛÛfiÙÂÚ· ÂÏÏÂ›ÔÓÙ· ‰fi-ÓÙÈ· Î·È ÏÈÁfiÙÂÚ· ÂÌÊÚ·¯ı¤ÓÙ· ‰fiÓÙÈ·, ÛÂ ‚·ıÌfi ÛÙ·ÙÈ-ÛÙÈÎ¿ ÛËÌ·ÓÙÈÎfi ÛÂ Û¯¤ÛË ÌÂ ·˘Ù¿ Ô˘ ‰ÂÓ ÊÔ‚Ô‡ÓÙ·Ó. AÓÙ›ıÂÙ·, ÔÈ Doerr Î·È Û˘Ó3 ‰ÂÓ ‚Ú‹Î·Ó Û¯¤ÛË ÌÂÙ·Í‡ Ô‰Ô-ÓÙÈ·ÙÚÈÎÔ‡ Êfi‚Ô˘ Î·È ·ÚÈıÌÔ‡ ÂÏÏÂÈfiÓÙˆÓ ‰ÔÓÙÈÒÓ, fiÌˆ˜ÔÈ Ô‰ÔÓÙÈ·ÙÚÈÎ¿ ÊÔ‚ÈÛÌ¤ÓÔÈ Â›¯·Ó ÙÚÈÏ¿ÛÈÔ ·ÚÈıÌfi ÙÂ-ÚË‰ÔÓÈÛÌ¤ÓˆÓ ÂÈÊ·ÓÂÈÒÓ ‰ÔÓÙÈÒÓ Î·È Û¯Â‰fiÓ ÌÈÛ¤˜ ÂÌ-ÊÚ·¯ıÂ›ÛÂ˜ ÂÈÊ¿ÓÂÈÂ˜ ‰ÔÓÙÈÒÓ ÛÂ Û¯¤ÛË ÌÂ ·˘ÙÔ‡˜ Ô˘‰ÂÓ ÊÔ‚Ô‡ÓÙ·Ó, ÛÂ ‚·ıÌfi ÛÙ·ÙÈÛÙÈÎ¿ ÛËÌ·ÓÙÈÎfi. OÈArmfield Î·È Û˘Ó5 Û˘ÌÊˆÓÔ‡Ó ÛÙÔ fiÙÈ ÔÈ Ô‰ÔÓÙÈ·ÙÚÈÎ¿ ÊÔ-‚ÈÛÌ¤ÓÔÈ ¤¯Ô˘Ó ÂÚÈÛÛfiÙÂÚ· ÂÏÏÂ›ÔÓÙ· ‰fiÓÙÈ· ÛÂ Û¯¤-ÛË ÌÂ ·˘ÙÔ‡˜ Ô˘ ÊÔ‚Ô‡ÓÙ·È Ï›ÁÔ ‹ Î·ıfiÏÔ˘, ÂÓÒ ˘Ô-ÛÙËÚ›˙Ô˘Ó fiˆ˜ Î·È ¿ÏÏÔÈ40 fiÙÈ Ô ·ÚÈıÌfi˜ ÙˆÓ ÂÏÏÂÈfi-ÓÙˆÓ ‰ÔÓÙÈÒÓ Â›Ó·È ÈÔ Â˘·›ÛıËÙÔ˜ «‰Â›ÎÙË˜» ÙË˜ ÛÙÔÌ·-ÙÈÎ‹˜ ̆ ÁÂ›·˜ ÛÂ Û¯¤ÛË ÌÂ ÙÔÓ DMFT, ÛÂ Î·Ù·ÛÙ¿ÛÂÈ˜ Ô‰Ô-ÓÙÈ·ÙÚÈÎÔ‡ Êfi‚Ô˘. A˘Ùfi Èı·ÓÒ˜ ÂÍËÁÂ› ÁÈ·Ù› ‰ÂÓ ‚Ú¤-ıËÎÂ Û¯¤ÛË ÌÂÙ·Í‡ DMFT Î·È Ô‰ÔÓÙÈ·ÙÚÈÎÔ‡ Êfi‚Ô˘ ÛÂ·˘Ù‹ ÙËÓ ¤ÚÂ˘Ó·. ™˘ÁÎÂÎÚÈÌ¤Ó·, ÔÈ Schuller Î·È Û˘Ó40 ‚Ú‹-Î·Ó fiÙÈ ·Ó Î·È ‰ÂÓ ˘‹Ú¯Â ÛÙ·ÙÈÛÙÈÎ¿ ÛËÌ·ÓÙÈÎ‹ ‰È·ÊÔ-Ú¿ ÛÙÔÓ DMFT ÌÂÙ·Í‡ ·ÙfiÌˆÓ ÌÂ ˘ÂÚ‚ÔÏÈÎfi Î·È ‹ÈÔ

15



16


Ô‰ÔÓÙÈ·ÙÚÈÎfi Êfi‚Ô, Ô ·ÚÈıÌfi˜ ÙˆÓ ÂÏÏÂÈfiÓÙˆÓ ‰ÔÓÙÈÒÓ‹Ù·Ó Û¯Â‰fiÓ 50% ˘„ËÏfiÙÂÚÔ˜ ÌÂÙ·Í‡ ·˘ÙÒÓ ÌÂ ˘ÂÚ-‚ÔÏÈÎfi Ô‰ÔÓÙÈ·ÙÚÈÎfi Êfi‚Ô ÛÂ Û¯¤ÛË ÌÂ ·˘ÙÒÓ ÌÂ ‹ÈÔÔ‰ÔÓÙÈ·ÙÚÈÎfi Êfi‚Ô. A˘Ùfi Èı·ÓÒ˜ ·ÈÙÈÔÏÔÁÂ›Ù·È ·fi ÙÔfiÙÈ Ù· ¿ÙÔÌ· ÌÂ ˘ÂÚ‚ÔÏÈÎfi Êfi‚Ô ÚÔÙÈÌÔ‡Ó Ù· ‰fiÓÙÈ·ÙÔ˘˜ Ó· ÂÍ·¯ıÔ‡Ó ·Ú¿ Ó· ·ÔÎ·Ù·ÛÙ·ıÔ‡Ó41.

™YM¶EPA™MATA·) H Û˘¯ÓfiÙËÙ· ÙÔ˘ Ô‰ÔÓÙÈ·ÙÚÈÎÔ‡ Êfi‚Ô˘ ÛÂ ‰Â›ÁÌ· ÂÓË-Ï›ÎˆÓ ·ÛıÂÓÒÓ Ê·›ÓÂÙ·È Ó· Â›Ó·È ˘„ËÏ‹. ‚) O Ô‰ÔÓÙÈ·ÙÚÈÎfi˜ Êfi‚Ô˜ ‰Â›¯ÓÂÈ Ó· Û¯ÂÙ›˙ÂÙ·È ÌÂ ÔÚÈ-ÛÌ¤Ó· ÂÈ‰ËÌÈÔÏÔÁÈÎ¿ ̄ ·Ú·ÎÙËÚÈÛÙÈÎ¿ fiˆ˜ ÙÔ Ê‡ÏÔ Î·ÈÙËÓ ËÏÈÎ›· ·ÏÏ¿ ‰ÂÓ ‚Ú¤ıËÎÂ Ó· Û¯ÂÙ›˙ÂÙ·È ÌÂ ÙË ÌfiÚ-ÊˆÛË Î·È ÙÔÓ ÙfiÔ ‰È·ÌÔÓ‹˜. Á) O Ô‰ÔÓÙÈ·ÙÚÈÎfi˜ Êfi‚Ô˜ Ê·›ÓÂÙ·È Ó· ¤¯ÂÈ ‰˘ÛÌÂÓÂ›˜ÂÈÙÒÛÂÈ˜ ÛÙË ÛÙÔÌ·ÙÈÎ‹ ˘ÁÂ›· ÙˆÓ ·ÛıÂÓÒÓ.

SUMMARY

Dental fear. Frequency and consequences for theoral health of adult patients.

Kokkore A., Donta A., Karayianni K.

hellenic hospital dentistry 4: 11-17, 2011

Dental fear is described as the emotional situationembracing anxiety, stress and fear leading the dentalpatients towards irregular dental care or else renderingthe visit to the dentist very unpleasant. The frequency ofhigh dental fear has been reported at the range of 4,20%to 20,9%. Such variation could be explained by theapplication of different modes of measuring dental fear,variation of sampling methods or any other factors suchas the country the research is taking place.Aim: to combine dental fear with oral health status andspecific epidemiological characteristics and to evaluatethe relationship between dental fear and the frequency andcausation of visiting the dentist. Material and methods: 101 adult patients completed aquestionnaire. The questionnaire consisted of two measuresof Dental fear (MDAS & FS) and questions forepidemiological characteristics and oral health habits. Dataabout oral health status have been obtained after the clinicaland radiological examination of the patients.Results: the frequency of high dental fear in the sampleas measured by the FS and MDAS was 13,86% and 14,85%respectively. The correlation between FS & MDAS was0,84. Females were significantly more likely to report highdental fear compared with males and there were significantdifferences by age. No significant correlation was foundbetween dental fear and educational level, residence,frequency and causation of visiting the dentist. Significantcorrelation was observed between dental fear and numberof missed teeth and number of filled teeth. Conclusions: the frequency of dental fear in the sampleof adult patients appears to be high. Dental fear appears

to be related with age, sex, having adverse effects into theoral health status.

Key words: Dental fear; oral health; adult patients

BIB§IO°PAºIA1 Gatcel RJ, Ingersoll BD, Bowman L, Robertson MC, Walker

C: The prevalence of dental fear and avoidance: a recentsurvey study. JADA 1983; 107(4): 609-10.

2 Milgrom P, Fiset L, Melnick S, Weinstein P: The prevalenceand practice management consequences of dental fear in amajor US city. JADA 1988; 116: 641-7.

3 Doerr PA, Lang PW, Nyquist LV: Factors associated withdental anxiety. JADA 1998; 129:1111-19.

4 Chanpong B, Haas DA, Locker D: Need and demand forsedation or general anesthesia in dentistry: a nationalsurvey of the Canadian population. Anesth Prog 2005; 52: 3-11.

5 Armfield JM, Stewart JF, Spencer JA: The vicious cycle ofdental fear: exploring the interplay between oral health,service utilization and dental fear. BMC Oral Health 2007,7:1.

6 Armfield JM, Slade GD, Spencer JA: Cognitive vulnerabilityand dental fear. BMC Oral Health 2008; 8:2.

7 Locker D, Lidell A: Clinical correlates of dental anxietyamong older adults. Community Dent Oral Epidemiol 1992;20(6): 372-5.

8 Greenberg LS: Emotion focused therapy: coaching clientsto work through their feelings. American PsychologicalAssociation Press 2002. Washington. 2002.

9 Belzung C, Chevalley C: Models of complexity: theexamples of emotions. Behavioral and Brain Sciences 2001;24(6): 1053-57.

10 Berggren U, Meynert G: Dental fear and avoidance: causes,symptoms and consequences. JADA 1984; 109: 247-51.

11 Locker D, Lidell A, Burman D: Dental fear and anxiety in anolder population. Community Dent Oral Epidemiol 1991; 19:120-4.

12 Moore R, Brodsgaard I, Rosenberg N: The contribution ofembarrassment to phobic dental anxiety: a qualitativeresearch study. BMC Psychiatry 2004; 4:10.

13 Nicolas E, Collado V, Faulks D, Bullier B: A national crosssectional survey of dental anxiety in the French adultpopulation. BMC Oral Health 2007; 7:12.

14 AÓÙˆÓ·Î¿ÎË ™: Afi ÙÔ Û‡ÌÙˆÌ· ÛÙÔ ‚›ˆÌ·. æ˘¯ÔÏÔÁÈÎ¤˜ÔÙÈÎ¤˜ ÙË˜ O‰ÔÓÙÈ·ÙÚÈÎ‹˜. ¶ÔÏ‡ÙÚÔÔÓ. Aı‹Ó·. 2007.

15 Domoto PK, Weinstein P, Melnick S, Ohmura M, Ushida H,Ohmachi K, Hori M: Results of a dental fear survey in Japan:implications for dental public health in Asia. CommunityDent Oral Epidemiol 1988; 16(4): 199-201.

16 M¿ÚÙË˜ X: O ÚÔ‚ÏËÌ·ÙÈÎfi˜ ·ÛıÂÓ‹˜ ÙÔ˘ Ô‰ÔÓÙÈ·ÙÚÂ›Ô˘.EÎ‰. Z‹Ù·. Aı‹Ó·. 1995.

17 Hakeberg M, Berggren U: A radiographic study of dentalhealth in adult patients with dental anxiety. Community DentOral Epidemiol 1993; 21(1): 27-30.

18 Wisloff TF, Vassend O, Asmsyr O: Dental anxiety, utilizationof dental services, and DMF status in Norwegian militaryrecruits. Community Dent Health 1995; 12(2): 100-3.

19 BÏ·ÛÈ¿‰Ë˜ K, BÂÏÂÁÚ¿ÎË˜ °, ™ÎÔ˘Ù¤ÚË˜ X: ™˘ÛÙ‹Ì·Ù· Ì¤-ÙÚËÛË˜ ÙË˜ ÔÈfiÙËÙ·˜ ˙ˆ‹˜ ÛÂ Û¯¤ÛË ÌÂ ÙË ÛÙÔÌ·ÙÈÎ‹ ˘-ÁÂ›·. EÏÏ ™ÙÔÌ XÚÔÓ 2008; 52: 75-80.

20 TÚÈ¯fiÔ˘ÏÔ˜ ¢: EÈ‰ËÌÈÔÏÔÁ›·. AÚ¯¤˜ - Ì¤ıÔ‰ÔÈ - ÂÊ·ÚÌÔ-Á¤˜. ¶·ÚÈÛÈ¿ÓÔ˜. Aı‹Ó·.1982.


21 World Health Organization: Oral Health Surveys. Basicmethods. 4th ed. Geneva.1997.

22 Gatcel RJ: The prevalence of dental fear and avoidance:expanded adult and recent adolescent surveys. JADA 1989;118: 591-3.

23 Humphris GM, Morrison T, Lindsay SJE: The ModifiedDental Anxiety Scale: validation and United Kingdom norms.Community Dent Health 1995; 12: 143-50.

24 Coolidje T, Arapostathis KA, Emmanouil D, Dabarakis N,Patrikiou A, Economides N et al: Psychometric properties ofGreek versions of the Modified Dental Anxiety Scale (MDAS)and the Dental Fear Scale (DFS). BMC Oral Health 2008;8:29.

25 Vassend O: Anxiety, pain and discomfort associated withdental treatment. Behav Res Ther 1993; 31: 659-66.

26 Locker D, Shapiro D, Lidell A: Who is dentally anxious?Concordance between measures of dental anxiety.Community Dent Oral Epidemiol 1996; 24: 346-5.

27 Hakeberg M, Berggren U, Carlsson SG: Prevalence ofdental anxiety in an adult population in a major urban area inSweden. Community Dent Oral Epidemiol 1992; 20: 97-101.

28 Lindsay S, Jackson C: Fear of routine dental treatment inadults: Its nature and management. Psychology and Health;8: 135-54.

29 Schuurs A, Hoogstraten J: Appraisal of dental anxiety andfear questionnaires: a review. Community Dent OralEpidemiol 1993; 21: 329-39.

30 Tunk EP, Firat D, Onur OD: Reliability and validity theModified Dental Anxiety Scale in a Turkish population.Community Dent Oral Epidemiol 2005; 33: 357-62.

31 Yuan S, Freeman R, Lahti S., Lloyd-Williams F, Humpris G:Some psychometric properties of the Chinese version of themodified anxiety scale with cross validation. Health and

Quality of Life Outcomes 2008; 6: 22.32 Moore R, Birn H, Kirkegaard E: Prevelance and

characteristics of dental anxiety in Danish adults.Community Dent Oral Epidemiol 1993; 21(5): 292-96.

33 Weinstein P, Shimono T, Domoto P: Dental fear in Japan:Okayama prefecture school study of adolescents andadults. Anesth Prog 1993; 39(6): 215-20.

34 Milgrom P, Vignesha H, Weinstein P: Adolescent dental fearand control:prevalence and theiritical implications. BehavRes Ther 1992; 30(4): 367-73.

35 Locker D, Lidell A: Stability of dental anxiety scale scores: alongitudinal study of older adults. Community Dent OralEpidemiol 1995; 23: 259-61.

36 Mellor AC: Dental anxiety and attendance in the north-westof England. J Dent 1992; 20(4): 207-10.

37 Stouthard ME: Prevalance of dental anxiety in TheNetherlands. Community Dent Oral Epidemiol 1990; 18(3):139-42.

38 Lo GL: The use of dental services by adult Singaporeans.Singapore Dent J 1993; 18(1): 22-25.

39 Nutall NM: Initial development of a scaleto measure dentalindifference. Community Dent Oral Epidemiol 1996; 24(2):112-16.

40 Sculler AA, Willumsen T: Are there differences in oral healthand oral health behavior between individuals with high andlow dental fear? Community Dent Oral Epidemiol 2003;31(2): 116-21.

40 Bouma J, Uitenbroek D, Westert G, Schaub RM, Van de PoelF: Pathways to full mouth extraction. Community Dent OralEpidemiol 1987; 15(6): 301-5.

17ÂÏÏËÓÈÎ‹ ÓÔÛÔÎÔÌÂÈ·Î‹ Ô‰ÔÓÙÈ·ÙÚÈÎ‹ 4: 11-17, 2011


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* AÓ·ÏËÚˆÙ‹˜ K·ıËÁËÙ‹˜ KÈÓËÙ‹˜ ¶ÚÔÛıÂÙÈÎ‹˜ EK¶A

AÓ·‰ËÌÔÛ›Â˘ÛË ·fi ÙÔ O‰ÔÓÙÈ·ÙÚÈÎfi B‹Ì·. OÎÙÒ‚ÚÈÔ˜ 2010ÿ‰Ú˘Ì· ÚÔ¤ÏÂ˘ÛË˜: O‰ÔÓÙÈ·ÙÚÈÎ‹ ™¯ÔÏ‹ EK¶A

ÚÒÙÔ ¤ÙÔ˜ ÙˆÓ ÛÔ˘‰ÒÓ Ì·˜. M¤Û· ·fi ÙË Û¯¤ÛË ·˘-Ù‹ ÂÚÓ¿ÂÈ ÛÙËÓ Î˘ÚÈÔÏÂÍ›· fiÏÔ ÙÔ „˘¯ÔÛ˘Ó·ÈÛıËÌ·ÙÈ-Îfi ÔÈÎÔ‰fiÌËÌ· ÙÔ˘ ·ÛıÂÓ‹ Î·È ·Û˘ÓÂ›‰ËÙ· ‰È·Ï¤ÎÂÙ·ÈÌÂ ÂÎÂ›ÓÔ ÙÔ˘ Ô‰ÔÓÙÈ¿ÙÚÔ˘. H ¤ÓÓÔÈ· ÙË˜ ÌÂÙ·‚›‚·ÛË˜·ÔÙÂÏÂ› Ì›· ·fi ÙÈ˜ ÌÂÁ·ÏÂÈÒ‰ÂÈ˜ Û˘ÏÏ‹„ÂÈ˜ ÙÔ˘Sigmund Freud (1856-1939)2 ÛÙËÓ ÔÚÂ›· ıÂÌÂÏ›ˆÛË˜ÙË˜ „˘¯·Ó·Ï˘ÙÈÎ‹˜ ÛÎ¤„Ë˜ Î·È Ú·ÎÙÈÎ‹˜. H „˘¯·Ó¿-Ï˘ÛË ̂ ˜ ‰ÔÌËÌ¤ÓË ıÂˆÚ›· ÙË˜ ÂÁÎ·Ù¿ÛÙ·ÛË˜ Î·È ··Ú-Ù›ˆÛË˜ ÙÔ˘ „˘¯ÈÎÔ‡ ÔÚÁ¿ÓÔ˘ Î·È Î·Ù¿ Û˘Ó¤ÂÈ· ÙË˜ ·Ó-ıÚÒÈÓË˜ „˘¯Ô·ıÔÏÔÁ›·˜ ÂÍÂÏ›¯ıËÎÂ, ÂÌÏÔ˘Ù›ÛÙËÎÂ,·ÌÊÈÛ‚ËÙ‹ıËÎÂ ˆ˜ ÌË ÙÂÎÌËÚÈÔ‡ÌÂÓË, ·ÏÏ¿ ÙÂÏÈÎ¿ ·-Ú¤ÌÂÈÓÂ Ì›· ·fi ÙÈ˜ ÛËÌ·ÓÙÈÎfiÙÂÚÂ˜ Î·Ù·ÎÙ‹ÛÂÈ˜ ÙÔ˘ ·Ó-ıÚÒÈÓÔ˘ ÓÂ‡Ì·ÙÔ˜ ÙÔÓ ·ÈÒÓ· Ô˘ ¤Ú·ÛÂ. Œ¯ÂÈ Ì¿-ÏÈÛÙ· ˘ÔÛÙËÚÈ¯ıÂ› ˆ˜ ÔÈ ÎÚ·‰·ÛÌÔ› Ô˘ ÚÔÍ¤ÓËÛÂË Ó¤· „˘¯·Ó·Ï˘ÙÈÎ‹ ıÂˆÚ›· ¤ÌÔÈ·˙Â ÌÂ ÂÎÂ›ÓÔ˘˜ Ô˘ Â›-¯·Ó ÚÔÎ·Ï¤ÛÂÈ Ë ÎÔÛÌÔÏÔÁ›· ÙÔ˘ °·ÏÈÏ·›Ô˘ ÙÔÓ 17Ô ·È-ÒÓ· Î·È Ë ¢·Ú‚ÈÓÈÎ‹ ‚ÈÔÏÔÁ›· ÙÔÓ 19Ô ·ÈÒÓ·. °È· ÚÒÙËÊÔÚ¿ ÛÙË Û‡Á¯ÚÔÓË ÂÔ¯‹ Ô ÏfiÁÔ˜ ÌÂÙ·ÙÚ¤ÂÙ·È ÛÂ ıÂ-Ú·Â˘ÙÈÎfi ÂÚÁ·ÏÂ›Ô Î·È Ô ·ÛıÂÓ‹˜ ·ÓÙÈÌÂÙˆ›˙ÂÙ·È ÌÂ-Ù·Í‡ ¿ÏÏˆÓ Î·È ˆ˜ ÊÔÚ¤·˜ ÌÂÙ·Û¯ËÌ·ÙÈÛÌÔ‡ ÙË˜ ·ÓÙÈ-ÎÂÈÌÂÓÈÎ‹˜ Ú·ÁÌ·ÙÈÎfiÙËÙ·˜. K·È Ï¤ÌÂ ÛÙË Û‡Á¯ÚÔÓËÂÔ¯‹ ÁÈ·Ù› Ë ıÂÚ·Â˘ÙÈÎ‹ ‰‡Ó·ÌË ÙÔ˘ ÏfiÁÔ˘ Â›¯Â ‹‰Ë·ÍÈÔÔÈËıÂ› ÛÙÈ˜ Ì˘ÛÙËÚÈ·Î¤˜ KÔÚ˘‚·ÓÙÈÎ¤˜, EÏÂ˘Û›ÓÈÂ˜Î·È ¢ÈÔÓ˘ÛÈ·Î¤˜ ÙÂÏÂÙ¤˜ Î·È ÛÙÈ˜ ıÂÚ·Â˘ÙÈÎ¤˜ ÂÁÎÔÈÌ‹-ÛÂÈ˜ ÛÙ· AÛÎÏËÈÂ›· Î·È ÛÙ· Ì·ÓÙÂ›· ÙË˜ ·Ú¯·ÈfiÙËÙ·˜.H ÌÂÙ·‚›‚·ÛË(transfert, transference)3,4 ˘Ô‰ËÏÒÓÂÈ ‰ÈÂÚ-Á·Û›· Ô˘ ÛÙÔ ·˘ÛÙËÚ¿ „˘¯·Ó·Ï˘ÙÈÎfi Â‰›Ô ÂÚÈÏ·Ì-‚¿ÓÂÈ ÙËÓ Â·Ó¿ÏË„Ë ÚˆÙÔÙ‡ˆÓ ÙË˜ ·È‰ÈÎ‹˜ ˙ˆ‹˜Ù· ÔÔ›· ‚ÈÒÓÔÓÙ·È ÌÂ ¤ÓÙÔÓÔ ÙÔ ·›ÛıËÌ· ÙË˜ ÂÈÎ·ÈÚfi-ÙËÙ·˜. O Freud ˘ÔÛÙËÚ›˙ÂÈ fiÙÈ ˘Ú‹Ó·˜ ·˘ÙÒÓ ÙˆÓ ·È-‰ÈÎÒÓ Úˆ(ÙÔ)Ù‡ˆÓ ‰ÂÓ Â›Ó·È Ù›ÔÙÂ ¿ÏÏÔ ·fi Ù· ÁÔ-ÓÂ˚Î¿ ÌÔÚÊÔÂ›‰ˆÏ· (imago), ÂÛˆÙÂÚÈÎÂ˘Ì¤ÓÂ˜ ‰ËÏ·‰‹·Ó··Ú·ÛÙ¿ÛÂÈ˜ ÙÔ˘ ·Ù¤Ú·, ÙË˜ ÌËÙ¤Ú·˜, ÙˆÓ ·‰ÂÏ-ÊÒÓ Î·È ›Ûˆ˜ Î¿ÔÈˆÓ ÛËÌ·ÓÙÈÎÒÓ ¿ÏÏˆÓ ÚÔÛÒˆÓ.MÂ ¿ÏÏ· ÏfiÁÈ· ÚfiÎÂÈÙ·È ÁÈ· Â·ÓÂÓÂÚÁÔÔ›ËÛË ·Û˘-ÓÂ›‰ËÙˆÓ Û˘Ó·ÈÛıËÌ¿ÙˆÓ Î·È ÂÈı˘ÌÈÒÓ Ô˘ ÂÂÓ‰‡Ô-ÓÙ·È ÛÂ ¤Ó· Û˘ÁÎÂÎÚÈÌ¤ÓÔ Ï·›ÛÈÔ Û¯¤ÛÂˆÓ ÛÙÔ Â‰Ò Î·ÈÙÒÚ·. H ÌÂÙ·‚›‚·ÛË, ÚÔ¸fiıÂÛË Î·È ÂÚÁ·ÏÂ›Ô ÛÙËÓ „˘-¯·Ó·Ï˘ÙÈÎ‹ Ú·ÎÙÈÎ‹, ˘ÔÎÚ‡ÙÂÙ·È ‹ Î·È Î·ıÔÚ›˙ÂÈ ÙÈ˜ÔÈÎ›ÏÂ˜ Û¯ÂÛÈ·Î¤˜ ‰ÔÌ¤˜ ÛÙË ̇ ˆ‹ ÙÔ˘ ·ÓıÚÒÔ˘ fiˆ˜Ë Û¯¤ÛË Î·ıËÁËÙ‹-Ì·ıËÙ‹, ÁÈ·ÙÚÔ‡-·ÛıÂÓ‹, ÓÂ˘Ì·ÙÈ-ÎÔ‡-ÂÍÔÌÔÏÔÁÔ‡ÌÂÓÔ˘ ÎÏ. MÂÙ·‚È‚·ÛÙÈÎ¤˜ ·ÓÙÈ‰Ú¿-ÛÂÈ˜, ¯ˆÚ›˜ Ó· ÙÈ˜ ÔÓÔÌ¿˙ÂÈ ‚¤‚·È· ¤ÙÛÈ, ÂÚÈÁÚ¿ÊÂÈ Î·ÈÔ ¶Ï¿ÙˆÓ ÛÙÔÓ £Â·›ÙËÙÔ5, ·Ó·ÊÂÚfiÌÂÓÔ˜ ÛÙËÓ Â›‰Ú·-ÛË ÙË˜ ‰È‰·ÛÎ·Ï›·˜ ÙÔ˘ ™ˆÎÚ¿ÙË. £· Ï¤Á·ÌÂ Û˘ÓÂÒ˜ˆ˜ Ô ·ÛıÂÓ‹˜ ÂÈÏ¤ÁÔÓÙ·˜ ÙÔÓ ÁÈ·ÙÚfi ÙÔ˘ ÌÂÙ·Ê¤ÚÂÈ¤Ó· ÊÔÚÙ›Ô ÚÔÛ‰ÔÎÈÒÓ Î·È ÂÓ›ÔÙÂ ·ÌÊÈı˘ÌÈÎÒÓ ÛÙ¿ÛÂ-ˆÓ ÛÙËÚÈÁÌ¤ÓˆÓ ÛÙÈ˜ ·ÚÂÏıÔÓÙÈÎ¤˜ ÙÔ˘ ÂÌÂÈÚ›Â˜, Î˘-Ú›ˆ˜ ·fi Ù· ÚfiÛˆ· ÂÍÔ˘Û›·˜ ÙˆÓ ·È‰ÈÎÒÓ ÙÔ˘ ¯Úfi-ÓˆÓ. E‰Ò ı· ÌÔÚÔ‡ÛÂ Î¿ÔÈÔ˜ Ó· ÚˆÙ‹ÛÂÈ. K·È Ô ÁÈ·-ÙÚfi˜ ÙÈ Î¿ÓÂÈ; AÓ·ÌÊ›‚ÔÏ· ÔÈ Û˘ÁÎÂÎÚÈÌ¤ÓÂ˜ ÛÙ¿ÛÂÈ˜ ÙˆÓ·ÛıÂÓÒÓ ˘ÚÔ‰ÔÙÔ‡Ó ¤Ó· Ï¤ÁÌ· Û˘Ó·ÈÛıËÌ·ÙÈÎÒÓ ·ÓÙÈ-‰Ú¿ÛÂˆÓ Î·È ÛÙÔ ÁÈ·ÙÚfi. TÔ Ê¿ÛÌ· ÙˆÓ Û˘Ó·ÈÛıËÌ¿ÙˆÓ·˘ÙÒÓ ÂÎÙÂ›ÓÂÙ·È ·fi ÙÔÓ ı˘Ìfi Î·È ÙË ‰˘ÛÊÔÚ›· Ì¤¯ÚÈÙËÓ Î·Ù·ÓfiËÛË, ÙË ˙ÂÛÙ·ÛÈ¿, ÙËÓ ÙÚ˘ÊÂÚfiÙËÙ· ‹ ·ÎfiÌ·ÙËÓ ̆ ÔÎÚ˘ÙfiÌÂÓË ‹ ÂÌÊ·Ó‹ ÂÚˆÙÈÎ‹ ‰È¤ÁÂÚÛË. H ·ÓÙÈ-ÌÂÙ·‚›‚·ÛËÏÔÈfiÓ (contre transfert, counter transference)Â›Ó·È ÙÔ Û‡ÓÔÏÔ ÙˆÓ ·ÓÙÈ‰Ú¿ÛÂˆÓ ÙÔ˘ ÁÈ·ÙÚÔ‡ ·¤Ó·ÓÙÈÛÙÔÓ ·ÛıÂÓ‹ Î·È ÂÈ‰ÈÎfiÙÂÚ· ÛÙË ÌÂÙ·‚›‚·ÛË ÙÔ˘ ·ÛıÂ-

Ó‹. E›Ó·È ÚÔÊ·Ó¤˜ fiÙÈ Ë ·ÓÙÈÌÂÙ·‚›‚·ÛË ÙÔ˘ ÁÈ·ÙÚÔ‡·ÓÙÏÂ› ·fi ÙËÓ ·ı¤·ÙË ‰ÂÍ·ÌÂÓ‹ ÙÔ˘ ‰ÈÎÔ‡ ÙÔ˘ ·Û˘ÓÂ›-‰ËÙÔ˘. MÂÚÈÎ¤˜ ÊÔÚ¤˜, fiˆ˜ ‰È·›ÛÙˆÛÂ Ë Melanie Klein4

ÛÙÈ˜ ÌÂÏ¤ÙÂ˜ ÙË˜ ÁÈ· ÙËÓ „˘¯ÔÛ˘Ó·ÈÛıËÌ·ÙÈÎ‹ ˙ˆ‹ ÙÔ˘‚Ú¤ÊÔ˘˜, Ë ÛÙ·ıÂÚ‹ Î·È Ì·ÎÚÔ¯ÚfiÓÈ· ÌÂÙ·‚È‚·ÛÙÈÎ‹›ÂÛË, ÛÙËÓ ÂÚ›ÙˆÛ‹ Ì·˜ ÂÓfi˜ ·ÛıÂÓ‹ ÛÙÔ ÁÈ·ÙÚfi ÙÔ˘,ÌÔÚÂ› ÙÂÏÈÎ¿ Ó· Ô‰ËÁ‹ÛÂÈ ÙÔÓ ÙÂÏÂ˘Ù·›Ô ÛÂ Î·ıÔ‰Ë-ÁÔ‡ÌÂÓÂ˜ Ë Î·Ï‡ÙÂÚ· Â·ÁÒÌÂÓÂ˜* ÛÎ¤„ÂÈ˜ Î·È Û˘Ó·È-Ûı‹Ì·Ù·, Ô˘ ÂÓ Ù¤ÏÂÈ Ù·˘Ù›˙ÔÓÙ·È ÌÂ ÂÛˆÙÂÚÈÎ¤˜ ·Ó·-·Ú·ÛÙ¿ÛÂÈ˜ ÙˆÓ Û˘Ó·ÈÛıËÌ¿ÙˆÓ ÙÔ˘ ›‰ÈÔ˘ ÙÔ˘ ·ÛıÂ-Ó‹. ¶ÚfiÎÂÈÙ·È ‰ËÏ·‰‹ ÁÈ· ¤Ó· ÌË¯·ÓÈÛÌfi ·Ô‚ÔÏ‹˜ Î·ÈÛÙË Û˘Ó¤¯ÂÈ· ÂÈÛ·ÁˆÁ‹˜ ÙÌËÌ¿ÙˆÓ ÙÔ˘ Â·˘ÙÔ‡ ÙÔ˘ ·ÛıÂ-Ó‹ (Û˘Ó‹ıˆ˜ ·ÚÓËÙÈÎÒÓ Ô˘ ‰ÂÓ Ù· ·ÓÙ¤¯ÂÈ Ô ›‰ÈÔ˜) ÛÙÔÓıÂÚ·Â˘Ù‹ ÙÔ˘ ÌÂ ÙÂÏÈÎfi ÛÎÔfi ÙÔÓ ·Û˘ÓÂ›‰ËÙÔ ¤ÏÂÁ¯ÔÙÔ˘ ÙÂÏÂ˘Ù·›Ô˘. H Û˘ÌÂÚÈÊÔÚÈÎ‹ Î·È Û˘Ó·ÈÛıËÌ·ÙÈÎ‹ ·˘Ù‹ ¯ÂÈÚ·ÁÒÁË-ÛË ÙÔ˘ ÂÚÈ‚¿ÏÏÔÓÙÔ˜, Ô˘ ·Ú·ÙËÚÂ›Ù·È fi¯È Û¿ÓÈ· ÛÂÓÔÛËÏÂ˘ÙÈÎ¤˜ ÌÔÓ¿‰Â˜ „˘¯ÈÎÒÓ ÓÔÛËÌ¿ÙˆÓ Î·È È‰È·›ÙÂ-Ú· ·fi ·Ú·ÓÔ˚ÎÔ‡˜ ̄ ·Ú·ÎÙ‹ÚÂ˜, ÔÓÔÌ¿˙ÂÙ·È ÚÔ‚ÔÏÈ-Î‹ ‹ ÚÔ‚ÏËÙÈÎ‹ Ù·‡ÙÈÛË (projective identification). MÂÙ¿KÏ·˚ÓÈÎÔ› Û˘ÁÁÚ·ÊÂ›˜ (Heimann 1950, Ogden 1979, Bion1988)6,7,11 Â·ÓÂÍ¤Ù·Û·Ó ÙËÓ ¤ÓÓÔÈ· ÙË˜ ÚÔ‚ÔÏÈÎ‹˜ Ù·‡-ÙÈÛË˜ ‰›ÓÔÓÙ·˜ ¤ÌÊ·ÛË ÛÙÈ˜ Â˘Ú‡ÙÂÚÂ˜ ÂÈÎÔÈÓˆÓÈ·Î¤˜Û˘ÓÈÛÙÒÛÂ˜ ÙË˜ Î·È Î·ıfiÚÈÛ·Ó ÙËÓ ·Ó·ÁÎ·ÈfiÙËÙ· ÙË˜‡·ÚÍË˜ fi¯È ÌfiÓÔ ÂÓfi˜ ÚÔ‚ÔÏ¤·, ·ÏÏ¿ Î·È ÂÓfi˜ Î·-Ù¿ÏÏËÏÔ˘ Î·Ù¿ ÂÚ›ÙˆÛË ‰¤ÎÙË ÁÈ· ÙËÓ ÂÁÎ·Ù¿ÛÙ·ÛËÙÔ˘ Ê·ÈÓÔÌ¤ÓÔ˘. ŒÙÛÈ Ë ÚÔ‚ÔÏÈÎ‹ Ù·‡ÙÈÛË Ê·›ÓÂÙ·È Ó·ÂÓ˘¿Ú¯ÂÈ (Ó· ˘fi-ÎÂÈÙ·È) ÛÂ Î¿ıÂ Û¯¤ÛË Û˘ÓÙÚÔÊÈÎfi-ÙËÙ·˜ Î·È Û˘Ó·ÈÛıËÛ›·˜. E›Ó·È ÚÔÊ·Ó¤˜ ÏÔÈfiÓ ÁÈ·Ù›¯ÂÈÚ·ÁˆÁÔ‡ÌÂÓ· ıÂÚ·Â˘ÙÈÎ¿ Û¯‹Ì·Ù· ·fi ÙÔ˘˜ ›‰ÈÔ˘˜ÙÔ˘˜ ·ÛıÂÓÂ›˜ ‰ÂÓ Â›Ó·È Û¿ÓÈ· ÛÙËÓ Î·ı’ ËÌ¤Ú· ÎÏÈÓÈÎ‹Ú¿ÍË. ¶ÚfiÎÂÈÙ·È ÁÈ· ¤Ó· ÂÈÎÔÈÓˆÓÈ·Îfi ·È¯Ó›‰È ‰Ú¿-ÛË˜ - ·ÓÙ›‰Ú·ÛË˜ ÙfiÛÔ ·ÏÔ˚Îfi Î·È ·Ú¯·˚Îfi, fiÛÔ ÔÏ˘-Û‡ÓıÂÙÔ Î·È Â›Î·ÈÚÔ. O ·Ì‡ËÙÔ˜ ÁÈ·ÙÚfi˜ ›Ûˆ˜ ‰ÂÓ ÙÔÛ˘ÓÂÈ‰ËÙÔÔÈÂ› ·ÏÏ¿ Î·È ·Ó ·ÎfiÌ· ÙÔ ˘Ô„È·ÛÙÂ› ı· ÙÔÂÎÏÔÁÈÎÂ‡ÛÂÈ, Î·Ù·È¤˙ÔÓÙ·˜ ÙËÓ Û˘Ó·ÈÛıËÌ·ÙÈÎ‹ ÙÔ˘·fiÎÚÈÛË ̂ ˜ ·ÓÙÈÂ·ÁÁÂÏÌ·ÙÈÎ‹ ‹ ÂÈÎ›Ó‰˘ÓË. K·È fiÌˆ˜Ë Î·Ù·ÓfiËÛË Î·È ‰È·¯Â›ÚÈÛË ÙË˜ ·ÓÙÈÌÂÙ·‚›‚·ÛË˜ ÌÔ-ÚÂ› Ó· ·Ô‰ÂÈ¯ıÂ› ¯Ú‹ÛÈÌË ÛÙËÓ Â‰Ú·›ˆÛË ÌÈ·˜ ÂÚÁ·-ÛÈ·Î‹˜ Û˘ÌÌ·¯›·˜, Ô˘ fiˆ˜ Î·È ÛÙËÓ „˘¯·Ó¿Ï˘ÛË ·Ô-ÙÂÏÂ› ÙÔ Ê¤ÚÔÓ ÛÒÌ· (corpus) ÂÓÙfi˜ ÙÔ˘ ÔÔ›Ô˘ ÔÏÔ-ÎÏËÚÒÓÔÓÙ·È ÌÂ ÂÈÙ˘¯›· Ù· ıÂÚ·Â˘ÙÈÎ¿ Û¯‹Ì·Ù·. M›·Ì¤ıÔ‰Ô˜ ·ÍÈÔÔ›ËÛË˜ ÙˆÓ ·Ú·¿Óˆ „˘¯·Ó·Ï˘ÙÈÎÒÓ‰Â‰ÔÌ¤ÓˆÓ ÁÈ· ÙËÓ ÂÍ·ÛÊ¿ÏÈÛË ÙË˜ ÂÚÁ·ÛÈ·Î‹˜ Û˘Ì-Ì·¯›·˜ Â›Ó·È Ë Ì¤ıÔ‰Ô˜ BATHE Î·È ·ÊÔÚ¿ fiÏÔ ÙÔ Ê¿ÛÌ·ÙˆÓ ÎÏÈÓÈÎÒÓ È·ÙÚÈÎÒÓ ÂÈ‰ÈÎÔÙ‹ÙˆÓ, fiÔ˘ Î˘ÚÈ·Ú¯Â› Ë·ÓÙÈ·Ú¿ıÂÛË ÁÈ·ÙÚÔ‡-·ÛıÂÓ‹.

*MÂ ÙËÓ ¤ÓÓÔÈ· Ô˘ ·ÔÚÚ¤ÂÈ ·fi ÙËÓ ËÏÂÎÙÚÔÌ·ÁÓËÙÈ-Î‹ Â·ÁˆÁ‹ (Electric Induction) ‰ËÏ·‰‹ ÙËÓ ÂÌÊ¿ÓÈÛËËÏÂÎÙÚÈÛÌÔ‡ ÂÍ·ÈÙ›·˜ Ì·ÁÓËÙÈÎÔ‡ Â‰›Ô˘

H ME£O¢O™ BATHEH Ì¤ıÔ‰Ô˜ BATHE8 ÚˆÙÔ·ÚÔ˘ÛÈ¿ÛÙËÎÂ ·fi ÙÔ˘˜Marian Stuart Î·È Joseph Lieberman ÛÙÔ ‚È‚Ï›Ô ÙÔ˘˜ TheFifteen Minute Hour ÙÔ 1993 ÂÓÒ ·ÎÔÏÔ‡ıËÛ·Ó Î·È ¿Ï-ÏÂ˜ ‰ËÌÔÛÈÂ‡ÛÂÈ˜ ÛÙÔ ı¤Ì· ·˘Ùfi. ¶ÚˆÙ·Ú¯ÈÎfi˜ ÛÎÔfi˜ÙÔ˘˜ ‹Ù·Ó Ë ÁÚ‹ÁÔÚË ıÂÌÂÏ›ˆÛË ÌÈ·˜ Û¯¤ÛË˜ ÂÌÈÛÙÔ-

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Û‡ÓË˜ ÌÂ ÙÔÓ ·ÛıÂÓ‹ Î·È Ë ·‰Ú‹ Î·Ù·ÁÚ·Ê‹ Î·Ù·ÛÙ¿-ÛÂˆÓ ¿Á¯Ô˘˜ Î·È ÛÙÚÂ˜. KÏÂÈ‰È¿ ÛÙË ‰È·‰ÈÎ·Û›· ·˘Ù‹ Â›-Ó·È Î·Ù¿ ÛÂÈÚ¿Ó Ë ÈÎ·ÓfiÙËÙ· ÙÔ˘ ÁÈ·ÙÚÔ‡ Ó· ·ÎÔ‡ÂÈ ÙÔÓ·ÛıÂÓ‹, Ó· ·Ú¤¯ÂÈ ÛÙ‹ÚÈÍË, Ó· ÚÔÎ·ÏÂ› Î·È Ó· ·ÓÙ·-Ó·ÎÏ¿ Û˘Ó·ÈÛı‹Ì·Ù·, Ó· ‰Â›¯ÓÂÈ ÛÂ‚·ÛÌfi Î·È Ù¤ÏÔ˜ Ó·ıÂÌÂÏÈÒÓÂÈ ÂÚÁ·ÛÈ·Î‹ Û˘ÌÌ·¯›·. O ·ÛıÂÓ‹˜ Ú¤ÂÈ Ó·ÂÈ ÁÈ· ÌÂÚÈÎ¿ ÏÂÙ¿ ÙËÓ ÈÛÙÔÚ›· ÙÔ˘ ̄ ˆÚ›˜ ‰È·ÎÔ‹, ·-Ú¿ ÙËÓ Û˘Ó‹ıË Ú·ÎÙÈÎ‹ Ì·˜ Ó· ̇ ËÙ¿ÌÂ ÁÚ‹ÁÔÚ· Î·È Î¿-ÔÈÂ˜ ÊÔÚ¤˜ ·‰È¿ÊÔÚ· ‹ ·˘Ù·Ú¯ÈÎ¿, ÔÏÏ¤˜ ÏÂÙÔÌ¤-ÚÂÈÂ˜. K·ÏÒ˜ ‹ Î·ÎÒ˜ Ë Â·ÚÎ‹˜ ·ÓÙÈÌÂÙÒÈÛË ÙÔ˘ Û˘-ÓÔÏÈÎÔ‡ È·ÙÚÈÎÔ‡ ‹ ÛÙËÓ ÂÚ›ÙˆÛ‹ Ì·˜ Ô‰ÔÓÙÈ·ÙÚÈÎÔ‡ÚÔ‚Ï‹Ì·ÙÔ˜ ÂÚÈÏ·Ì‚¿ÓÂÈ Î·È ÙÈ˜ Û˘Ó·ÈÛıËÌ·ÙÈÎ¤˜ Û˘-ÓÈÛÙÒÛÂ˜ ÙÔ˘. ™˘ÓÂÒ˜ Â›Ó·È ıÂÌÂÏÈÒ‰Â˜ Ó· Î·Ù·ÓÔ‹-ÛÔ˘ÌÂ ÙÈ ·ÎÚÈ‚Ò˜ ··Û¯ÔÏÂ› ÙÔÓ ·ÛıÂÓ‹, ÙÈ Ô ·ÛıÂÓ‹˜ÚÔÛ‰ÔÎ¿ ·fi ÂÌ¿˜ Î·È Ù¤ÏÔ˜ ÁÈ·Ù› Ô ·ÛıÂÓ‹˜ ÚÔ-ÛÙÚ¤¯ÂÈ ÁÈ· ıÂÚ·Â›· ÙË Û˘ÁÎÂÎÚÈÌ¤ÓË ÛÙÈÁÌ‹. H Ì¤ıÔ-‰Ô˜ BATHE (Background, Affect, Trouble, Handling,Empathy) Â›Ó·È Ì›· ·Ï‹ ·ÛıÂÓÔÎÂÓÙÚÈÎ‹ ‰È·‰ÈÎ·Û›· Ô˘ÂÚÈÏ·Ì‚¿ÓÂÈ 4 ÂÚˆÙ‹ÛÂÈ˜ ÂÌÓÂ˘ÛÌ¤ÓÂ˜ ·fi ÙÈ˜ ÎÏ·-ÛÈÎ¤˜ „˘¯ÔıÂÚ·Â˘ÙÈÎ¤˜ ÌÂıfi‰Ô˘˜. H ÚÒÙË ÂÚÒÙËÛË[ÙÈ Û˘Ì‚·›ÓÂÈ ÛÙË ˙ˆ‹ Û·˜ ‹ ÙÈ Û·˜ ··Û¯ÔÏÂ›;] ·ÊÔÚ¿ÙÔ Background ‰ËÏ·‰‹ ÙËÓ ‰ÈÂÚÂ‡ÓËÛË ÙÔ˘ ·Ú·ÛÎËÓ›-Ô˘, ÙË˜ ÂÚÈÚÚ¤Ô˘Û·˜ „˘¯ÔÛ˘Ó·ÈÛıËÌ·ÙÈÎ‹˜ Î·Ù¿ÛÙ·-ÛË˜ ÙÔ˘ ·ÛıÂÓ‹. AÚÎÂÙÔ› ·ÛıÂÓÂ›˜ ÌÈÏÔ‡Ó ÌfiÓÔÈ ÙÔ˘˜Û¯ÂÙÈÎ¿ ÌÂ Ù· ˙ËÙ‹Ì·Ù· ·˘Ù¿ ÚÈÓ Î·Ó ÂÚˆÙËıÔ‡Ó. H‰Â‡ÙÂÚË ÂÚÒÙËÛË [ˆ˜ ·ÈÛı¿ÓÂÛÙÂ ÁÈ’ ·˘Ù¿;] ·ÓÙÏÂ› ÏË-ÚÔÊÔÚ›Â˜ ÁÈ· ÙÔ Û˘Ó·›ÛıËÌ· (Affect) Ô˘ ÂÎÊÚ¿˙ÂÈ Ô·ÛıÂÓ‹˜ ÂÚÈÁÚ¿ÊÔÓÙ·˜ ÙÔ ·Ú·ÛÎ‹ÓÈÔ ÙË˜ ˙ˆ‹˜ ÙÔ˘.H ÙÚ›ÙË ÂÚÒÙËÛË [ÙÈ Â›Ó·È ·˘Ùfi Ô˘ Û·˜ Ù·Ï·ÈˆÚÂ› ‹ Û·˜·ÓËÛ˘¯Â› ÂÚÈÛÛfiÙÂÚÔ;] ·ÊÔÚ¿ ÙÔ Trouble Î·È Ô‰ËÁÂ›ÛÙËÓ Û˘Ì‚ÔÏÈÎ‹ Û‡ÓÔ„Ë ÙÔ˘ ÚÔ‚Ï‹Ì·ÙÔ˜ ·fi ÙÔÓ ·ÛıÂ-Ó‹, ÂÓÒ Ë Ù¤Ù·ÚÙË ÂÚÒÙËÛË [ˆ˜ ¯ÂÈÚ›˙ÂÛÙÂ ÙÔ Úfi‚ÏË-Ì· ·˘Ùfi;] Handling, ‚ÔËı¿ Ó· Î·Ù·ÓÔ‹ÛÔ˘ÌÂ ‹ Ó· ˘Ô-„È·ÛÙÔ‡ÌÂ ÙÈ˜ Û˘Ó·ÈÛıËÌ·ÙÈÎ¤˜ ·Ú·Î·Ù·ı‹ÎÂ˜ Î·È ÙÔ˘˜ÌË¯·ÓÈÛÌÔ‡˜ ̄ ÂÈÚÈÛÌÔ‡ ÙÔ˘ ÚÔ‚Ï‹Ì·ÙÔ˜. T¤ÏÔ˜ ÌÈ· ‰È-Î‹ Ì·˜ ÙÔÔı¤ÙËÛË ÙÔ˘ Ù‡Ô˘ [ı· Ú¤ÂÈ Ó· Â›Ó·È ÔÏ‡‰‡ÛÎÔÏÔ ÁÈ· Û·˜ Ë, Î·Ù·Ï·‚·›Óˆ ÙÔ Úfi‚ÏËÌ¿ Û·˜] ˘Ô-‰ËÏÒÓÂÈ ÙËÓ Î·Ù·ÓfiËÛË ÙÔ˘ ÚÔ‚Ï‹Ì·ÙÔ˜ (Empathy)Ì·˜ÙÔÔıÂÙÂ› ÛÂ ı¤ÛË Û˘Ì¿Û¯ÔÓÙÔ˜ Î·È ÁÂÊ˘ÚÔÔÈÂ› ÙÔ·Ú¯ÈÎfi ¯¿ÛÌ·.

™HMEIA ¶PO™OXH™E›Ó·È ÚÔÊ·Ó¤˜ fiÙÈ Ë Î·Ù¿ÏÏËÏË ̄ Ú‹ÛË ÙÔ˘ ÏfiÁÔ˘ Î·È ËÂÚÌËÓÂ˘ÙÈÎ‹ ‰ÂÍÈfiÙËÙ· ÙÔ˘ ÁÈ·ÙÚÔ‡ Î·ıÔÚ›˙Ô˘Ó ÙËÓ ·Ô-ÙÂÏÂÛÌ·ÙÈÎfiÙËÙ· ÙË˜ ÌÂıfi‰Ô˘. ™·Ó Ì¤ıÔ‰Ô˜ ÂÈÎÔÈÓˆ-Ó›·˜ ̄ ÚÂÈ¿˙ÂÙ·È ¿ÛÎËÛË, Â·Ó¿ÏË„Ë, ÊÂÈ‰Ò Î·È ›Ûˆ˜ Î¿-ÔÈÔ Ù·Ï¤ÓÙÔ Î·È Û›ÁÔ˘Ú· ‰ÂÓ ÚfiÎÂÈÙ·È ÁÈ· ·ÓÙÈÔ›ËÛËÙÔ˘ Â·ÁÁ¤ÏÌ·ÙÔ˜ ÙÔ˘ „˘¯ÔÏfiÁÔ˘. OÈ Û˘ÁÁÚ·ÊÂ›˜ ̂ ÛÙfi-ÛÔ ÙÔÓ›˙Ô˘Ó ÙËÓ ·ÔÊ˘Á‹ ÂÌÏÔÎ‹˜ ÛÙÔ Â˘Ú‡ÙÂÚÔ Û˘-Ó·ÈÛıËÌ·ÙÈÎfi Úfi‚ÏËÌ· ÙÔ˘ ·ÛıÂÓ‹ ÌÂ Û˘Ì‚Ô˘Ï¤˜ ‹ ¿Ï-ÏË˜ Ê‡ÛÂˆ˜ ˘ÔÛÙËÚÈÎÙÈÎ¤˜ ·ÚÂÌ‚¿ÛÂÈ˜ Ô˘ Î·È ÂÈ-Î›Ó‰˘ÓÂ˜ Â›Ó·È Î·È ÍÂÊÂ‡ÁÔ˘Ó ·fi ÙËÓ Ô˘Û›· Î·È Ù· ˙Ë-ÙÔ‡ÌÂÓ· ÙË˜ ÌÂıfi‰Ô˘. T¤ÏÔ˜ Ë Ì¤ıÔ‰Ô˜ ‰ÂÓ ı· Ú¤ÂÈÓ· ÂÊ·ÚÌfi˙ÂÙ·È ÛÂ ‚·Ú‡ÙÂÚÂ˜ ÂÚÈÙÒÛÂÈ˜ fiˆ˜ ÛÂ „˘-¯ˆÙÈÎÔ‡˜ ·ÛıÂÓÂ›˜, ÛÂ ·ÛıÂÓÂ›˜ ÌÂ ·˘ÙÔÎÙÔÓÈÎ‹ ÚÔ-‰È¿ıÂÛË, ‹ ·ÎfiÌ· Î·È ÛÂ ·ÛıÂÓÂ›˜ ÌÂ ÛÔ‚·Ú¤˜ ‰È·Ù·-Ú·¯¤˜ ÚÔÛˆÈÎfiÙËÙ·˜, Ô˘ Ô‡Ùˆ˜ ‹ ¿ÏÏˆ˜ ‰ÂÓ ÂÌ›-ÙÔ˘Ó ÛÙÔ Û‡ÓËıÂ˜ Ô‰ÔÓÙÈ·ÙÚÈÎfi ÂÏ·ÙÔÏfiÁÈÔ.

™XETIKA ME TI™ O¢ONTIATPIKE™ ANA°KE™ KAI TOAITHMA °IA £EPA¶EIA (NEEDS-DEMANDS)™ÙÔ ›‰ÈÔ Ì‹ÎÔ˜ Î‡Ì·ÙÔ˜ ÎÈÓÂ›Ù·È Î·È Ô ÚÔÛ‰ÈÔÚÈÛÌfi˜ÙˆÓ ·Ó·ÁÎÒÓ Î·È ÙˆÓ ·ÈÙËÌ¿ÙˆÓ ÁÈ· Ô‰ÔÓÙÈ·ÙÚÈÎ‹ ıÂ-Ú·Â›·. ¶ÚfiÎÂÈÙ·È ÁÈ· Û˘ÛÙËÌ·ÙÈÎ‹ - Ì·ÈÂ˘ÙÈÎ‹ - ‰È·‰È-Î·Û›· Ì¤Ûˆ Î·Ù¿ÏÏËÏ· ‰È·ÌÔÚÊˆÌ¤ÓˆÓ ÂÚˆÙ‹ÛÂˆÓ Î·ÈÎÏÈÓÈÎ‹˜ ÂÍ¤Ù·ÛË˜, Ô˘ Ú·ÁÌ·ÙÔÔÈÂ›Ù·È ÛÙË Ê¿ÛË ÙË˜ÚÒÙË˜ Â·Ê‹˜ ÌÂ ÙÔÓ ·ÛıÂÓ‹ Î·È ÙË Ï‹„Ë ÙÔ˘ ÈÛÙÔ-ÚÈÎÔ‡. EÚÂ˘ÓËÙÈÎ¤˜ ÂÚÁ·Û›Â˜ ÙÔ˘Ï¿¯ÈÛÙÔÓ ‰‡Ô ‰ÂÎ·Â-Ù›Â˜ ÚÈÓ9, ¤ÊÂÚ·Ó ÁÈ· ÚÒÙË ÊÔÚ¿ ÛÙÔ Êˆ˜ ÙÔ ÌÂÁ¿-ÏÔ Î›Ó‰˘ÓÔ ÙË˜ ÛÙÚÂ‚Ï‹˜ ÂÎÙ›ÌËÛË˜ ÙˆÓ Ú·ÁÌ·ÙÈÎÒÓ·Ó·ÁÎÒÓ ÁÈ· ıÂÚ·Â›·, Ô˘ ÔÊÂ›ÏÂÙ·È fi¯È ÌfiÓÔ ÛÙË ÚË-¯fiÙËÙ· ÙË˜ ÂÈÎÔÈÓˆÓ›·˜, ·ÏÏ¿ Î·È ÛÙÔÓ ÂÚÌËÓÂ˘ÙÈÎfiÌÔÓfiÏÔÁÔ ÙÔ˘ ÂÍÂÙ·ÛÙ‹. ¢ÂÓ Ú¤ÂÈ Ó· ÍÂ¯Ó¿ÌÂ fiÙÈ Ù·˘ÔÙÈı¤ÌÂÓ· ·ÓÙÈÎÂÈÌÂÓÈÎ¿ ÛÙÔÈ¯Â›· ·fi ÙËÓ È·ÙÚÈÎ‹ Î·ÈÔ‰ÔÓÙÈ·ÙÚÈÎ‹ ÈÛÙÔÚ›· ÙÔ˘ ·ÛıÂÓ‹ ÂÍ·ÚÙÒÓÙ·È ·fi ÙÈ˜‚·ı‡ÙÂÚÂ˜ ·ÓÙÈÏ‹„ÂÈ˜, ÙÈ˜ ·fi„ÂÈ˜ ·ÏÏ¿ Î·È ÙÈ˜ ·Ó·-ÌÓ‹ÛÂÈ˜ ÙÔ˘, ¤ÙÛÈ ÒÛÙÂ Û˘¯Ó¿ Ó· ÌËÓ Û˘Ì‚·‰›˙Ô˘Ó ÌÂÙÈ˜ ‰È·ÊÔÚÂÙÈÎ¤˜ ÂÚÌËÓÂ˘ÙÈÎ¤˜ ÂÎ‰Ô¯¤˜ ÙÔ˘ ÁÈ·ÙÚÔ‡(ÂÈÎ. 1). MÂ ¿ÏÏ· ÏfiÁÈ· Ù· ÁÂÁÔÓfiÙ· Â›Ó·È ¯ÚˆÌ·ÙÈÛÌ¤-Ó· ÌÂ Ù· Á˘·ÏÈ¿ Ì¤Û· ·fi Ù· ÔÔ›· ‚Ï¤ÂÈ Ô Î·ı¤Ó·˜ÙÔÓ ÎfiÛÌÔ Î·È ¿Ú· ··ÈÙÂ›Ù·È ÌÂÁ·Ï‡ÙÂÚË ÚÔÛ¿ıÂÈ·ÁÈ· ÙËÓ ·ÔÎÚ˘ÙÔÁÚ¿ÊËÛ‹ ÙÔ˘˜.

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EÈÎ. 1: AÓÙÈÎÂÈÌÂÓÈÎ¤˜ Î·È ˘ÔÎÂÈÌÂÓÈÎ¤˜ ·Ó¿ÁÎÂ˜ ÁÈ· ıÂ-Ú·Â›·. EÈÎfiÓ· Ô‰ÔÓÙÔÛÙÔÈ¯›·˜ ÌÂÙ¿ ·fi ÂÚ›Ô˘ 30¯ÚfiÓÈ· ¯Ú‹ÛË˜. ¶·Ú¿ ÙÔ ÁÂÁÔÓfi˜ fiÙÈ Ë Û˘ÁÎÂÎÚÈÌ¤ÓË Ô-‰ÔÓÙÔÛÙÔÈ¯›· ‰ÂÓ ÈÎ·ÓÔÔÈÂ› Û¯Â‰fiÓ Î·ÌÈ¿ Î·Ù·ÛÎÂ˘·ÛÙÈ-Î‹ ÚÔ‰È·ÁÚ·Ê‹ Û‡ÌÊˆÓ· ÌÂ ÙÔ˘˜ Î·ÓfiÓÂ˜ ÙË˜ ÂÈÛÙ‹-ÌË˜ Î·È ÙË˜ Ù¤¯ÓË˜ (¤ÏÏÂÈ„Ë Û˘ÁÎÚ¿ÙËÛË˜ Î·È ÛÙ‹ÚÈÍË˜,Î¿Ù·ÁÌ· ÙÂÚ˘Á›ˆÓ, ·ÔÙÚÈ‚‹ ‰ÔÓÙÈÒÓ, ÌË‰ÂÓÈÎ‹ ̆ ÁÈÂÈÓ‹,·ÓÂ·ÚÎ‹˜ ·ÈÛıËÙÈÎ‹ ÎÏ), Ë ËÏÈÎÈˆÌ¤ÓË ·ÛıÂÓ‹˜ ‰ËÏÒ-ÓÂÈ ·fiÏ˘Ù· ÈÎ·ÓÔÔÈËÌ¤ÓË Î·È ‰ÂÓ ÂÈ‰ÈÒÎÂÈ Î·ÓÂÓfi˜ Â›-‰Ô˘˜ ÂÈ‰ÈfiÚıˆÛË Ë ·ÓÙÈÎ·Ù¿ÛÙ·ÛË. ™ÙÔ ÚÔÛÙ·ÙÂ˘Ì¤ÓÔÂÚÈ‚¿ÏÏÔÓ fiÔ˘ ‰È·‚ÈÂ›, Ô ÂÚÈÔÚÈÛÌ¤ÓÔ˜ ¯·Ú·ÎÙ‹Ú·˜ÙˆÓ ÎÔÈÓˆÓÈÎÒÓ Û˘Ó·Ó·ÛÙÚÔÊÒÓ Î·È ÙÔ ÂÏÂÁ¯fiÌÂÓÔ ‰È·È-ÙÔÏfiÁÈÔ ‰ÈÎ·ÈÔÏÔÁÔ‡Ó ÂÓ Ì¤ÚÂÈ ÙËÓ ·Ú·¿Óˆ ÛÙ¿ÛË (°Ë-ÚÔÎÔÌÂ›Ô AıËÓÒÓ 1991)9.


OI I¢IAITEPOTHTE™ TH™ O¢ONTIATPIKH™ -™YM¶EPA™MATA¶·Ú¿ ÙË Ê·ÈÓÔÌÂÓÈÎ‹ ÙË˜ ·fiÛÙ·ÛË, Ë ÎÏÈÓÈÎ‹ Ô‰ÔÓÙÈ·-ÙÚÈÎ‹ ‰È·¯ÂÈÚ›˙ÂÙ·È ·ÛıÂÓÂ›˜ ÌÂ ÙÚfiÔ Ô˘ ÂÌ›ÙÂÈ ·fi-Ï˘Ù· ÛÂ fiÏÂ˜ ÙÈ˜ ·Ú·¿Óˆ „˘¯·Ó·Ï˘ÙÈÎ¤˜ ·Ú¯¤˜. OÈ·ÛıÂÓÂ›˜ ‚Ú›ÛÎÔÓÙ·È ÛÂ ÂÁÚ‹ÁÔÚÛË Î·È Í·ÏˆÌ¤ÓÔÈ ÛÙËÓÔ‰ÔÓÙÈ·ÙÚÈÎ‹ Î·Ú¤ÎÏ· ÛÂ ÛˆÌ·ÙÈÎ‹ ÂÁÁ‡ÙËÙ· ÌÂ ÙÔÓ/ÙËÓÔ‰ÔÓÙ›·ÙÚÔ. OÈ Û˘ÓÂ‰Ú›Â˜ Â›Ó·È Û˘Ó‹ıˆ˜ ÔÏÏ¤˜ Î·ıÈÂ-ÚÒÓÔÓÙ·˜ ÔÈÎ›ÏÔ˘˜ ÚfiÏÔ˘˜, Û˘Ì‚ÔÏÈÎ¿ ÈÛÔ‰‡Ó·Ì· Î·ÈÌÂÙ·‚È‚·ÛÙÈÎ¤˜ Û˘ÌÂÚÈÊÔÚ¤˜. O ÏfiÁÔ˜ Û˘Ó‹ıˆ˜ Ú¤ÂÈ.¶ÚfiÎÂÈÙ·È ÁÈ· ÌÈ· ÛÎËÓ‹, ÔÈÔÓÂ› ÈÛÙ‹ ÛÙÔ „˘¯·Ó·Ï˘ÙÈÎfi˘fi‰ÂÈÁÌ·. E›ÛË˜ ‰ÂÓ ı· Ú¤ÂÈ Ó· ÍÂ¯Ó¿ÌÂ ˆ˜ ÙÔ ÛÙfi-Ì·, ¤Ú· ·fi ÙËÓ ÔÏ˘‰È¿ÛÙ·ÙË Û˘Ì‚ÔÏ‹ ÙÔ˘ ÛÙËÓ ÂÍˆ-ÙÂÚÈÎ‹ ÂÈÎfiÓ·, ‰È·‰Ú·Ì·Ù›˙ÂÈ ÛËÌ·ÓÙÈÎfi ÚfiÏÔ ÛÙÔ ÚÒ-ÙÔ ÛÙ¿‰ÈÔ ÙË˜ ÏÈ‚È‰ÈÓÈÎ‹˜ ·Ó¿Ù˘ÍË˜ ÙÔ˘ ·ÓıÚÒÔ˘ Ô˘Î·Ù¿ ÙË ºÚÔ¸‰ÈÎ‹ ·ÏÏ¿ Î·È ÙÈ˜ ÌÂÙ¿ ºÚÔ¸‰ÈÎ¤˜ ÚÔÛÂÁ-Á›ÛÂÈ˜ Û˘Ì‚¿ÏÏÂÈ ÛÙË ÔÚÁ¿ÓˆÛË ÙˆÓ ·ÓÙÈÎÂÈÌÂÓÔÙÚfiˆÓÛ¯¤ÛÂˆÓ Î·È ÛÙË ‰È·ÌfiÚÊˆÛË ÙË˜ ÚÔÛˆÈÎfiÙËÙ·˜. T¤-ÏÔ˜ Î¿ÔÈ· ·Ó·ÊÔÚ¿ ı· Ú¤ÂÈ Ó· Î¿ÓÔ˘ÌÂ Î·È ÛÙÔ Û¯Â-ÙÈÎfi ÁÓˆÌÈÎfi, Ô˘ ˆ˜ ÎÈ‚ˆÙfi˜ ‰È·ÁÂÓÂ·ÏÔÁÈÎ‹˜10 Ï·˚Î‹˜ÛÔÊ›·˜ ‰ËÏÒÓÂÈ: ŸÔ˘ ÔÓÂ› ÙÔ ‰fiÓÙÈ, ÂÎÂ› ÎÈ Ë ÁÏÒÛÛ·ÎÚÔ‡ÂÈ.

SUMMARY

The dentist-patient relationship in the everyday dental practice

Karkazis H.


Although the establishment of a positive doctor-patientrelationship is essential for the delivery of high quality healthcare, every day practice reveals the lack of such a structured

model of communication. Especially for the dentalprofession with its technocratic and complex nature furthergood rapport and working alliance with the patients areimperative. The aim of this paper is to present somepsychodynamic aspects of the dentist-patient relationshipand to propose methods of communication.

Key words: dental practice; communication; treatmentplanning

BIB§IO°PAºIA1. K·ÚÎ·˙‹˜ H: ¢ËÌfiÛÈ· Ô‰ÔÓÙÈ·ÙÚÈÎ‹ ÂÎ·›‰Â˘ÛË Î·È ÂÏÂ‡-

ıÂÚË ·ÁÔÚ¿. EÏÏ NÔÛ O‰ÔÓÙ 2009; 2:67-69.2. Storr A: Freud: A very short introduction. Oxford Un. Press.

1989.3. Freud S: La technique psychanalytique. Paris. PUF. 1953,

Reed. 1981.4. Klein M: Envy and gratitude and other works 1946-1963.

Vintage. 1997.5. £ÂÔ‰ˆÚ·ÎfiÔ˘ÏÔ˜ IN: ¶Ï¿ÙˆÓÔ˜ £Â·›ÙËÙÔ˜. EÈÛ·ÁˆÁ‹,

·Ú¯·›Ô Î·È Ó¤Ô ÂÏÏËÓÈÎfi ÎÂ›ÌÂÓÔ. Aı‹Ó·: AÎ·‰ËÌ›· AıË-ÓÒÓ, K¤ÓÙÚÔÓ EÚÂ‡ÓË˜ ÙË˜ EÏÏËÓÈÎ‹˜ ºÈÏÔÛÔÊ›·˜.1980.

6. Heimann P: On countertransference. Int Journal ofPsychoanalysis 1950; 31:81-84.

7. Bion W. In: Melanie Klein today. (Ed. E. Spillius). Routledge.London. 1988:178-186.

8. Stuart MR, Lieberman JA: The fifteen minute hour. AppliedPsychotherapy for the primary care physician. 2nd ed.Westport. Conn: Praeger, 1993.

9. Karkazis H, Kossioni A: Dental treatment needs anddemands of an elderly institutionalised population in Athens.Eur J Prosthodont Rest Dent 1993; 1:157-163.

10. Abraham N, Torok M: L’ ecorce et la noyau, Paris, AubierFlammarion. 1978: 433.

11. Ogden T: On projective identification. Int Journal of Psycho-analysis 1979; 60:357-373.

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¢ÈÂ‡ı˘ÓÛË ÁÈ· ÂÈÎÔÈÓˆÓ›·:HÚ·ÎÏ‹˜ X. K·ÚÎ·˙‹˜AÓ·Ï. K·ıËÁËÙ‹˜ KÈÓËÙ‹˜ ¶ÚÔ-ÛıÂÙÈÎ‹˜, O‰ÔÓÙÈ·ÙÚÈÎ‹ ™¯ÔÏ‹EK¶A£Ë‚ÒÓ 2 °Ô˘‰‹, Aı‹Ó· 11527, ÙËÏ. 2107461212, e-mail: [email protected]

EI™A°ø°HH ÂÈÎÔÈÓˆÓ›· ÙÔ˘ Ô‰ÔÓÙÈ¿ÙÚÔ˘ ÌÂ ÙÔÓ ·ÛıÂÓ‹ ·ÔÙÂÏÂ›¤Ó· ÛËÌ·ÓÙÈÎfi ÎÂÊ¿Ï·ÈÔ ÛÙËÓ ¿ÛÎËÛË ÙÔ˘ Ô‰ÔÓÙÈ·ÙÚÈ-ÎÔ‡ Â·ÁÁ¤ÏÌ·ÙÔ˜. M¤¯ÚÈ ÚfiÛÊ·Ù· ÔÈ ÂÈÎÔÈÓˆÓÈ·Î¤˜‰ÂÍÈfiÙËÙÂ˜ «Ì·ı·›ÓÔÓÙ·Ó ÛÙËÓ Ú¿ÍË» Ì¤Û· ·fi ÙËÓ Â-·ÁÁÂÏÌ·ÙÈÎ‹ ÂÓ·Û¯fiÏËÛË Î·È ÂÌÂÈÚ›· ÙÔ˘ Ô‰ÔÓÙÈ¿-ÙÚÔ˘ Î·È ‰ÂÓ ‰È‰¿ÛÎÔÓÙ·Ó ÛÂ ÔÏÔÎÏËÚˆÌ¤ÓË ÌÔÚÊ‹ ÛÙ·ÚÔÁÚ¿ÌÌ·Ù· ÚÔÙ˘¯È·ÎÒÓ ÛÔ˘‰ÒÓ. OÈ Ô‰ÔÓÙ›·ÙÚÔÈ ·ÏÏËÏÂÈ‰ÚÔ‡Ó ÏÂÎÙÈÎ¿ ÌÂ ÙÔ˘˜ ·ÛıÂÓÂ›˜

ÙÔ˘˜ Ì¤Û· ÛÙ· Ï›Á· ÏÂÙ¿ ÙÔ˘ ·Ú¯ÈÎÔ‡ ¯·ÈÚÂÙÈÛÌÔ‡, ÙË˜Ï‹„Ë˜ ÈÛÙÔÚÈÎÔ‡, ÙË˜ Û˘˙‹ÙËÛË˜ ¿Óˆ ÛÙÔ Û¯¤‰ÈÔ ıÂ-Ú·Â›·˜ Î·È ÙË˜ ̄ ÔÚ‹ÁËÛË˜ Ô‰ËÁÈÒÓ. TÔ ÌÂÁ·Ï‡ÙÂÚÔ Ì¤-ÚÔ˜ ÙÔ˘ ¯ÚfiÓÔ˘ ÙÔ˘˜ ÌÂ ÙÔÓ ·ÛıÂÓ‹ ÂÍÂÏ›ÛÛÂÙ·È «ÛÈˆ-ËÏ¿» Î·Ù¿ ÙË ‰È¿ÚÎÂÈ· ÙË˜ ıÂÚ·Â›·˜, fiÔ˘ ÌÂÁ¿ÏË ÛË-Ì·Û›· ·›˙Ô˘Ó ÔÈ ÌÂ ÏÂÎÙÈÎ¤˜ ÌÔÚÊ¤˜ ÂÈÎÔÈÓˆÓ›·˜ (Ì¿-ÙÈ·, Î›ÓËÛË ̄ ÂÚÈÒÓ ÙÔ˘ ·ÛıÂÓ‹ ÎÏ). EÈÏ¤ÔÓ Û˘Ó·ÈÛı‹-Ì·Ù· ¿Á¯Ô˘˜, Û˘¯Ó¿ Î·È ·fi ÙÈ˜ ‰‡Ô ÏÂ˘Ú¤˜, Û˘ÓÔ‰Â‡-Ô˘Ó ÙË ‰È·‰ÈÎ·Û›·. E›Ó·È Û˘ÓÂÒ˜ ·Ó·ÁÎ·›Ô Ô Ô‰ÔÓÙ›·-ÙÚÔ˜ Ó· ‰È·ı¤ÙÂÈ ÙÈ˜ ‰ÂÍÈfiÙËÙÂ˜ ·˘Ù¤˜ Ô˘ ı· ÙÔ˘ ÂÈ-ÙÚ¤„Ô˘Ó ÙËÓ Î·Ï‡ÙÂÚË ÚÔÛ¤ÁÁÈÛË ÙˆÓ ·ÛıÂÓÒÓ ÙÔ˘ Î·ÈÎ˘Ú›ˆ˜ ÂÎÂ›ÓˆÓ Ô˘ ¿Û¯Ô˘Ó ·fi Ô‰ÔÓÙÈ·ÙÚÈÎfi ¿Á¯Ô˜ ‹·ÚÔ˘ÛÈ¿˙Ô˘Ó ‰˘ÛÎÔÏ›Â˜ ÂÈÎÔÈÓˆÓ›·˜ (¯. ÌÈÎÚ¿ ·È-‰È¿, ËÏÈÎÈˆÌ¤ÓÔÈ, ·ÏÏÔ‰·Ô›, ¿ÙÔÌ· ÌÂ „˘¯ÈÎ‹ ÓfiÛÔ, ·-ÓÔ˚ÎÔ› ·ÛıÂÓÂ›˜, ¿ÙÔÌ· ÌÂ ÚÔ‚Ï‹Ì·Ù· ·ÎÔ‹˜, fiÚ·ÛË˜ÎÏ.). H ŒÓˆÛË ÁÈ· ÙËÓ O‰ÔÓÙÈ·ÙÚÈÎ‹ EÎ·›‰Â˘ÛË ÛÙËÓ E˘ÚÒ-Ë (Association for Dental Education in Europe / ADEE)ÙËÓ ÔÔ›· ··ÚÙ›˙ÂÈ Ë ÏÂÈÔ„ËÊ›· ÙˆÓ O‰ÔÓÙÈ·ÙÚÈÎÒÓ™¯ÔÏÒÓ ÙË˜ ËÂ›ÚÔ˘ Î·È Ë ÔÔ›· Î·ÙÂ˘ı‡ÓÂÈ ÙÔ Û¯Â‰È·-ÛÌfi Î·È ÙË Û‡ÁÎÏÈÛË ÙˆÓ ÚÔÁÚ·ÌÌ¿ÙˆÓ ÛÔ˘‰ÒÓ, ÛÙÔÎÂ›ÌÂÓfi ÙË˜ Û¯ÂÙÈÎ¿ ÌÂ ÙÈ˜ ·Ó·ÁÎ·›Â˜ ‰ÂÍÈfiÙËÙÂ˜ ÙÔ˘ Ô-

E·ÁÁÂÏÌ·ÙÈÎfi ı¤Ì·

H ÂÈÎÔÈÓˆÓ›· ÙÔ˘ Ô‰ÔÓÙÈ¿ÙÚÔ˘ ÌÂ ÙÔÓ ËÏÈÎÈˆÌ¤ÓÔ ·ÛıÂÓ‹B·ÛÈÏÈÎ‹ P‹Á·1, AÓ·ÛÙ·Û›· E. KÔÛÈÒÓË2

OÈ ÂÈÎÔÈÓˆÓÈ·Î¤˜ ‰ÂÍÈfiÙËÙÂ˜ ·ÔÙÂÏÔ‡Ó ÛËÌ·ÓÙÈÎfi ÛÙÔÈ¯Â›Ô ÙË˜ ·ÏÏËÏÂÈ‰Ú·ÛÙÈÎ‹˜ Û¯¤-ÛË˜ ÙÔ˘ Ô‰ÔÓÙÈ¿ÙÚÔ˘ ÌÂ ÙÔÓ ·ÛıÂÓ‹ ÙÔ˘. OÈ Ô‰ÔÓÙ›·ÙÚÔÈ Ô˘ ÂÈÎÔÈÓˆÓÔ‡Ó ·ÔÙÂÏÂÛÌ·ÙÈ-ÎfiÙÂÚ· ÌÂ ÙÔ˘˜ ·ÛıÂÓÂ›˜ ÙÔ˘˜ ÂÈÙ˘Á¯¿ÓÔ˘Ó ̆ „ËÏfiÙÂÚÔ˘ ‚·ıÌÔ‡ Û˘ÓÂÚÁ·Û›· Ì·˙› ÙÔ˘˜. HÂÈÎÔÈÓˆÓ›· ‰È·ÎÚ›ÓÂÙ·È ÛÙË ÏÂÎÙÈÎ‹ Î·È ÛÙË ÌË ÏÂÎÙÈÎ‹, ·ÏÏ¿ Â›Ó·È ÛËÌ·ÓÙÈÎfi Ó· ÙÔÓÈÛÙÂ› fi-ÙÈ Î·È ÔÈ ‰‡Ô ÌÔÚÊ¤˜ ÂÈÎÔÈÓˆÓ›·˜ Â›Ó·È ·ÏÏËÏ¤Ó‰ÂÙÂ˜ Î·È ÛÙËÓ Ú¿ÍË ‰ÂÓ ÌÔÚÔ‡Ó Ó· ‰È·-¯ˆÚÈÛÙÔ‡Ó. OÈ ÂÈÎÔÈÓˆÓÈ·Î¤˜ ‰ÂÍÈfiÙËÙÂ˜ ·ÔÎÙÔ‡Ó È‰È·›ÙÂÚË ÛËÌ·Û›· ÛÙËÓ Û¯¤ÛË Ì·˜ ÌÂÙÔ˘˜ ËÏÈÎÈˆÌ¤ÓÔ˘˜ ·ÛıÂÓÂ›˜. ™ÙÔ˘˜ ·ÛıÂÓÂ›˜ ·˘ÙÔ‡˜ Û˘¯Ó¿ Î·Ù·ÁÚ¿ÊÔÓÙ·È ·ÈÛıËÙËÚÈ·Î¤˜ÂÏÏÂ›„ÂÈ˜ ÛÙËÓ ·ÎÔ‹ Î·È ÙËÓ fiÚ·ÛË, ‰È·Ù·Ú·¯¤˜ ÛÙËÓ ÚfiÛÊ·ÙË ÌÓ‹ÌË Î·È ¤ÎÙˆÛË ÙË˜ È-Î·ÓfiÙËÙ·˜ Ì¿ıËÛË˜ Î·È ÚÔÛ·ÚÌÔÁ‹˜ ÛÂ Î·ÈÓÔ‡ÚÁÈÂ˜ Î·Ù·ÛÙ¿ÛÂÈ˜. O Ô‰ÔÓÙ›·ÙÚÔ˜ ı·Ú¤ÂÈ Ó· ·ÍÈÔÔÈ‹ÛÂÈ ÌÈ· ÛÂÈÚ¿ ÙÂ¯ÓÈÎÒÓ ÁÈ· Ó· ÂÈÙ‡¯ÂÈ Î·Ï‡ÙÂÚË ÂÈÎÔÈÓˆÓ›· ÌÂ ÙÔÓ ËÏÈ-ÎÈˆÌ¤ÓÔ ·ÛıÂÓ‹, fiˆ˜ Ó· ·ÊÈÂÚÒÓÂÈ ÂÚÈÛÛfiÙÂÚÔ ̄ ÚfiÓÔ ÁÈ· Ó· ÙÔÓ «·ÎÔ‡ÛÂÈ» Î·È ÁÈ· Ó· Â-ÚÈÁÚ¿„ÂÈ ÙÈ˜ ·Ú·ÙËÚ‹ÛÂÈ˜ Î·È ÙÈ˜ Ô‰ËÁ›Â˜ ÙÔ˘, Ó· ·Ú·ı¤ÙÂÈ ÙÈ˜ ÏËÚÔÊÔÚ›Â˜ ÙÔ˘ ÌÂ ÔÏ-Ï·ÏÔ‡˜ ÙÚfiÔ˘˜ (ÁÚ·Ù¿ Î·È ÚÔÊÔÚÈÎ¿), Ó· Ï·Ì‚¿ÓÂÈ ÙËÓ Î·Ù¿ÏÏËÏË ı¤ÛË ÛÒÌ·ÙÔ˜ ˆ˜ÚÔ˜ ÙÔÓ ·ÛıÂÓ‹ ÙÔ˘, Ó· ‰È·ÙËÚÂ› ‚ÏÂÌÌ·ÙÈÎ‹ Â·Ê‹ Ì·˙› ÙÔ˘, Ó· ‰Â›¯ÓÂÈ ÛˆÌ·ÙÈÎ‹ ·ÓÙ·-fiÎÚÈÛË ÛÙË Û˘˙‹ÙËÛË, Ó· ·ÔÊÂ‡ÁÂÈ ÙË ¯Ú‹ÛË Ì¿ÛÎ·˜ fiÙ·Ó ÌÈÏ¿ÂÈ, Ó· ÊÚÔÓÙ›˙ÂÈ ÁÈ· ÙÔÓÎ·Ïfi ÊˆÙÈÛÌfi ÙÔ˘ ¯ÒÚÔ˘ Î·È ÁÈ· ÙËÓ ·Ô˘Û›· ıÔÚ‡‚ˆÓ ÂÚÈ‚¿ÏÏÔÓÙÔ˜.


§¤ÍÂÈ˜ ÎÏÂÈ‰È¿: ÂÈÎÔÈÓˆÓ›·, ÛˆÌ·ÙÈÎ‹ ¤ÎÊÚ·ÛË, ËÏÈÎÈˆÌ¤ÓÔ˜,Ô‰ÔÓÙ›·ÙÚÔ˜

1 §¤ÎÙÔÚ·˜ TEEA¶H, ™¯ÔÏ‹ AÓıÚˆÈÛÙÈÎÒÓ Î·È KÔÈÓˆÓÈÎÒÓ EÈ-ÛÙËÌÒÓ, ¶·ÓÂÈÛÙ‹ÌÈÔ ¶·ÙÚÒÓ2 E›ÎÔ˘ÚË K·ıËÁ‹ÙÚÈ· KÈÓËÙ‹˜ ¶ÚÔÛıÂÙÈÎ‹˜, O‰ÔÓÙÈ·ÙÚÈÎ‹ ™¯Ô-Ï‹ EK¶A

I‰Ú‡Ì·Ù· ÚÔ¤ÏÂ˘ÛË˜:™¯ÔÏ‹ AÓıÚˆÈÛÙÈÎÒÓ Î·È KÔÈÓˆÓÈÎÒÓ EÈÛÙËÌÒÓ, ¶·ÓÂÈÛÙ‹ÌÈÔ¶·ÙÚÒÓ Î·È O‰ÔÓÙÈ·ÙÚÈÎ‹ ™¯ÔÏ‹ EK¶A

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‰ÔÓÙÈ¿ÙÚÔ˘ Ô˘ ·ÔÊÔÈÙ¿ ·fi ÙÈ˜ O‰ÔÓÙÈ·ÙÚÈÎ¤˜ ™¯Ô-Ï¤˜ ÙÔÓ›˙ÂÈ ÙË ÛËÌ·Û›· ÙË˜ ÈÎ·ÓfiÙËÙ·˜ ÙË˜ ÂÈÎÔÈÓˆÓ›·˜ÌÂ ÙÔ˘˜ ·ÛıÂÓÂ›˜, ÙÈ˜ ÔÈÎÔÁ¤ÓÂÈ¤˜ ÙÔ˘˜, ÙÔ˘˜ ÊÚÔÓÙÈ-ÛÙ¤˜, ÙÔ˘˜ Û˘ÁÁÂÓÂ›˜ Î·È ÙÔ˘˜ ¿ÏÏÔ˘˜ Â·ÁÁÂÏÌ·Ù›Â˜ÙË˜ ̆ ÁÂ›·˜1. ™ÙÈ˜ ÈÎ·ÓfiÙËÙÂ˜ ·˘Ù¤˜ Û˘ÌÂÚÈÏ·Ì‚¿ÓÔÓÙ·ÈË ÈÎ·ÓfiÙËÙ· Î·Ù·ÁÚ·Ê‹˜ ÙË˜ ˘ÔÎÂÈÌÂÓÈÎ‹˜ ·Ó¿ÁÎË˜Î·È ÙˆÓ ÚÔÛ‰ÔÎÈÒÓ ÙÔ˘ ·ÛıÂÓ‹ Û¯ÂÙÈÎ¿ ÌÂ ÙËÓ Ô‰ÔÓÙÈ·-ÙÚÈÎ‹ ÙÔ˘ ıÂÚ·Â›· Î·È Ë ·ÓÙÈÌÂÙÒÈÛË ÙÔ˘ ¿Á¯Ô˘˜ ÙÔ˘. M›· Î·ÙËÁÔÚ›· ·ÛıÂÓÒÓ ÌÂ È‰È·›ÙÂÚÂ˜ ·Ó¿ÁÎÂ˜ ÛÙËÓ ÂÈ-ÎÔÈÓˆÓÈ·Î‹ ÚÔÛ¤ÁÁÈÛË Â›Ó·È ÔÈ ËÏÈÎÈˆÌ¤ÓÔÈ. TÔ Ê˘ÛÈÔ-ÏÔÁÈÎfi Á‹Ú·˜ Û˘ÓÔ‰Â‡ÂÙ·È ·fi ÙË ÌÂ›ˆÛË ÙË˜ ÏÂÈÙÔ˘Ú-ÁÈÎ‹˜ Â¿ÚÎÂÈ·˜ ÔÚÁ¿ÓˆÓ Î·È Û˘ÛÙËÌ¿ÙˆÓ. ™˘¯Ó¿ Î·Ù·-ÁÚ¿ÊÔÓÙ·È ·ÈÛıËÙËÚÈ·Î¤˜ ÂÏÏÂ›„ÂÈ˜ ÛÙËÓ ·ÎÔ‹ (¯. ÚÂ-Û‚˘·ÎÔ˘Û›·) Î·È ÙËÓ fiÚ·ÛË (¯. Î·Ù·ÚÚ¿ÎÙË˜, ÚÂ-Û‚˘ˆ›·), ÔÈ ÔÔ›Â˜ ·ÔÙÂÏÔ‡Ó ÂÌfi‰ÈÔ ÛÙËÓ ÂÈÎÔÈÓˆ-Ó›· ÌÂ ÙÔÓ Ô‰ÔÓÙ›·ÙÚÔ, ‰È·Ù·Ú·¯¤˜ ÛÙËÓ ÚfiÛÊ·ÙË ÌÓ‹-ÌË, ‚Ú·‰‡ÙËÙ· ÛÎ¤„Ë˜, ÂÏ¿ÙÙˆÛË ÙË˜ ¤ÎÊÚ·ÛË˜ ÂÓıÔ˘-ÛÈ·ÛÌÔ‡, ÂÚÈÔÚÈÛÌ¤ÓÔ ÂÓ‰È·Ê¤ÚÔÓ ÁÈ· Û˘ÁÎÚ¿ÙËÛËÏËÚÔÊÔÚÈÒÓ, ÂÓÒ ÂÏ·ÙÙÒÓÔÓÙ·È Ë ÈÎ·ÓfiÙËÙ· Ì¿ıËÛË˜Î·È ÚÔÛ·ÚÌÔÁ‹˜ ÛÂ Î·ÈÓÔ‡ÚÁÈÂ˜ Î·Ù·ÛÙ¿ÛÂÈ˜2-6.H ·ÚÔ‡Û· ÂÚÁ·Û›· ¤¯ÂÈ ˆ˜ ÛÎÔfi Ó· ÔÚ›ÛÂÈ ÙËÓ ·ÔÙÂ-ÏÂÛÌ·ÙÈÎ‹ ÂÈÎÔÈÓˆÓ›· ÌÂÙ·Í‡ ÙÔ˘ Â·ÁÁÂÏÌ·Ù›· ÙË˜ ˘-ÁÂ›·˜ Î·È ÙÔ˘ ·ÛıÂÓ‹, Ó· ÙÔÓ›ÛÂÈ ÙË ÛËÌ·Û›· ÙË˜ ÛÙËÓ ¿-ÛÎËÛË ÙÔ˘ Ô‰ÔÓÙÈ·ÙÚÈÎÔ‡ Â·ÁÁ¤ÏÌ·ÙÔ˜, Ó· Î·Ù·ÁÚ¿-„ÂÈ Ù· ÛËÌ·ÓÙÈÎfiÙÂÚ· ÚÔ‚Ï‹Ì·Ù· Ô˘ ·ÚÔ˘ÛÈ¿˙ÔÓÙ·ÈÛÙËÓ ÂÈÎÔÈÓˆÓ›· Ô‰ÔÓÙÈ¿ÙÚÔ˘ Î·È ËÏÈÎÈˆÌ¤ÓÔ˘ ·ÛıÂÓ‹Î·È Ó· ÚÔÙÂ›ÓÂÈ ÙÚfiÔ˘˜ ·ÓÙÈÌÂÙÒÈÛË˜ ·˘ÙÒÓ ÙˆÓÚÔ‚ÏËÌ¿ÙˆÓ.

E¶IKOINøNIAŒÓ· ·Ïfi˜ ÔÚÈÛÌfi˜ ÙË˜ ·ÔÙÂÏÂÛÌ·ÙÈÎ‹˜ ÂÈÎÔÈÓˆÓ›·˜ÌÂÙ·Í‡ ÁÈ·ÙÚÔ‡ Î·È ·ÛıÂÓ‹ ÂÚÈÏ·Ì‚¿ÓÂÈ ÙËÓ ·ÓÙ·ÏÏ·-Á‹ ÏËÚÔÊÔÚÈÒÓ Ì¤Ûˆ ÏÂÎÙÈÎÒÓ Î·È ÌË ÏÂÎÙÈÎÒÓ ÌËÓ˘-Ì¿ÙˆÓ, Ë ÔÔ›· Ô‰ËÁÂ› ÛÙËÓ ÂÓÂÚÁ‹ Û˘ÌÌÂÙÔ¯‹ ÙˆÓ ·-ÛıÂÓÒÓ, ÛÙËÓ ÈÛÙ‹ ÂÊ·ÚÌÔÁ‹ ÙË˜ ÚÔÁÚ·ÌÌ·ÙÈÛÌ¤ÓË˜ıÂÚ·Â›·˜ Î·È ÛÙËÓ ·ÌÔÈ‚·›· ÈÎ·ÓÔÔ›ËÛË7. ™ÙË Û‡Á¯ÚÔÓË ‚È‚ÏÈÔÁÚ·Ê›· Ë ‰ÂÍÈfiÙËÙ· ÛÙËÓ ÂÈÎÔÈÓˆ-Ó›· ÔÚ›˙ÂÙ·È ·fi ‰‡Ô Û˘ÓÈÛÙÒÛÂ˜: ÙË ÏÂÎÙÈÎ‹ Î·È ÙË ÌËÏÂÎÙÈÎ‹ ÂÈÎÔÈÓˆÓ›·8. Y¿Ú¯ÂÈ fiÌˆ˜ ·ÚÎÂÙ‹ Û‡Á¯˘ÛËÛÙÔ Ù› ÂÚÈÏ·Ì‚¿ÓÂÈ Ë Î¿ıÂ Ì›· Û˘ÓÈÛÙÒÛ· Î·È ÛÙÔ ÔÈ·ÌÔÚÊ‹ ÂÈÎÔÈÓˆÓ›·˜ Â›Ó·È Ë ÈÔ ·ÔÙÂÏÂÛÌ·ÙÈÎ‹. ¶¤Ú·Ó·fi ·˘ÙfiÓ ÙÔÓ ÎÏ·ÛÈÎfi ‰È·¯ˆÚÈÛÌfi ¿Ú¯ÈÛÂ Ó· Î·Ù·ÁÚ¿-ÊÂÙ·È Î·È Ó· ·Ó·Ï‡ÂÙ·È Î·È ÌÈ· ¿ÏÏË ¤ÓÓÔÈ· ÈÔ ÔÏÈÛÙÈÎ‹,·˘Ù‹ ÙË˜ ÛˆÌ·ÙÈÎ‹˜ ¤ÎÊÚ·ÛË˜.

H §EKTIKH E¶IKOINøNIAH ÏÂÎÙÈÎ‹ ÂÈÎÔÈÓˆÓ›· ·Ó·Ê¤ÚÂÙ·È Û˘¯Ó¿ ÛÙÈ˜ Ï¤ÍÂÈ˜ Ô˘¯ÚËÛÈÌÔÔÈÔ‡ÌÂ ÁÈ· Ó· ÂÈÎÔÈÓˆÓ‹ÛÔ˘ÌÂ Î·È ÂÚÈÔÚ›˙Â-Ù·È ÛÙÔÓ ÚÔÊÔÚÈÎfi Î·È ÁÚ·Ùfi ÏfiÁÔ. M›· ·ÔÙÂÏÂÛÌ·-ÙÈÎ‹ ÏÂÎÙÈÎ‹ ÂÈÎÔÈÓˆÓ›· ÂÚÈÏ·Ì‚¿ÓÂÈ ‰ÂÍÈfiÙËÙÂ˜ ÛÙËÓÔÌÈÏ›· Î·È ÙËÓ ·ÎÚfi·ÛË Î·È ÈÔ Û˘ÁÎÂÎÚÈÌ¤Ó· ‰ÂÍÈfiÙËÙÂ˜ÛÙÔ˘˜ ·Ú·Î¿Ùˆ ÙÔÌÂ›˜9:(1) ÛÙË ¯Ú‹ÛË ÙˆÓ Îˆ‰ÈÎÒÓ ÂÈÎÔÈÓˆÓ›·˜ (¯. ·ÔÙÂÏÂ-ÛÌ·ÙÈÎ‹ ·ÎÚfi·ÛË Î·È Î·Ù·ÓfiËÛË ÙÔ˘ ÚÔÊÔÚÈÎÔ‡ Ïfi-ÁÔ˘, Î·Ù¿ÏÏËÏË ¯Ú‹ÛË ÙˆÓ Ï¤ÍÂˆÓ, ÙË˜ ÚÔÊÔÚ¿˜, ÙÔ˘Û˘ÓÙ·ÎÙÈÎÔ‡ Î·È ÙË˜ ÁÚ·ÌÌ·ÙÈÎ‹˜, ·ÔÙÂÏÂÛÌ·ÙÈÎ‹ ̄ Ú‹-ÛË ÙË˜ ÊˆÓ‹˜),

(2) ÛÙËÓ ·ÍÈÔÏfiÁËÛË ÙÔ˘ ÚÔÊÔÚÈÎÔ‡ ÌËÓ‡Ì·ÙÔ˜ (¯.ÚÔÛ‰ÈÔÚÈÛÌfi˜ ÙË˜ ‚·ÛÈÎ‹˜ È‰¤·˜ ÙÔ˘ ÌËÓ‡Ì·ÙÔ˜, ‰È·-¯ˆÚÈÛÌfi˜ ÙˆÓ ÁÂÁÔÓfiÙˆÓ ·fi ÙÈ˜ ·fi„ÂÈ˜, ·Ó·ÁÓÒÚÈÛËfiÙÂ Î¿ÔÈÔ˜ ‰ÂÓ Î·Ù·Ï·‚·›ÓÂÈ ÙÔ Ì‹Ó˘Ì¿ ÛÔ˘),(3) ÛÙÈ˜ ‚·ÛÈÎ¤˜ ÌÔÚÊ¤˜ ÚÔÊÔÚÈÎ‹˜ ÂÈÎÔÈÓˆÓ›·˜ (Û˘-ÓÔÙÈÎ‹ Î·È ÌÂ Û·Ê‹ÓÂÈ· ¤ÎÊÚ·ÛË È‰ÂÒÓ, ÙÂÎÌËÚÈˆÌ¤ÓË˘ÔÛÙ‹ÚÈÍË ÙË˜ ¿Ô„Ë˜, ÔÚÁ¿ÓˆÛË ÌËÓ˘Ì¿ÙˆÓ ÒÛÙÂ Ó·Á›ÓÔ˘Ó ·ÓÙÈÏËÙ¿ ·fi ÙÔ˘˜ ¿ÏÏÔ˘˜, Û‡ÓÙ·ÍË ÂÚˆÙ‹ÛÂ-ˆÓ ÁÈ· Ï‹„Ë ÏËÚÔÊÔÚ›·˜, ·ÔÙÂÏÂÛÌ·ÙÈÎ‹ ·¿ÓÙËÛËÂÚˆÙ‹ÛÂˆÓ, ·ÚÔ¯‹ Û˘ÓÔÙÈÎÒÓ Î·È ·ÎÚÈ‚ÒÓ Ô‰ËÁÈÒÓ,Û‡ÓÔ„Ë ÌËÓ˘Ì¿ÙˆÓ),(4) ÛÙÈ˜ ·ÓıÚÒÈÓÂ˜ Û¯¤ÛÂÈ˜ (ÂÚÈÁÚ·Ê‹ ÙË˜ ¿Ô„Ë˜ÙÔ˘ ¿ÏÏÔ˘, ÂÚÈÁÚ·Ê‹ ‰È·ÊÔÚÒÓ ÛÙÈ˜ ·fi„ÂÈ˜, ¤ÎÊÚ·ÛËÛ˘Ó·ÈÛıËÌ¿ÙˆÓ, ÂÎÙ¤ÏÂÛË ÎÔÈÓˆÓÈÎÒÓ ÙÂÏÂÙÔ˘ÚÁÈÎÒÓ).

H MH §EKTIKH E¶IKOINøNIAH ÌË ÏÂÎÙÈÎ‹ ÂÈÎÔÈÓˆÓ›· ·Ó·Ê¤ÚÂÙ·È ÛÙËÓ ·ÓıÚÒÈÓË Â-ÈÎÔÈÓˆÓ›· Ô˘ ·Ú¿ÁÂÙ·È ÌÂ ÔÔÈÔ‰‹ÔÙÂ ÙÚfiÔ ÂÎÙfi˜·fi ÙÈ˜ Ï¤ÍÂÈ˜8 Î·È ˘ÂÚ‚·›ÓÂÈ ÙÔÓ ÚÔÊÔÚÈÎfi Î·È ÁÚ·-Ùfi ÏfiÁÔ. TÔ ÌË ÏÂÎÙÈÎfi ÎÔÌÌ¿ÙÈ ÙË˜ Û˘ÌÂÚÈÊÔÚ¿˜ ıÂ-ˆÚÂ›Ù·È ·fi ÔÏÏÔ‡˜ ÂÚÂ˘ÓËÙ¤˜ fiÙÈ ·ÔÙÂÏÂ› ÙÔ ÌÂÁ·-Ï‡ÙÂÚÔ Ì¤ÚÔ˜ ÌÈ·˜ ÂÈÎÔÈÓˆÓÈ·Î‹˜ Ú¿ÍË˜10-12. ŒÚÂ˘ÓÂ˜ÁÓˆÛÙÒÓ ıÂˆÚËÙÈÎÒÓ ÙË˜ ÌË ÏÂÎÙÈÎ‹˜ ÂÈÎÔÈÓˆÓ›·˜8,10,13-21

·Ó·‰ÂÈÎÓ‡Ô˘Ó ÔÏÏ¤˜ ‰È·ÛÙ¿ÛÂÈ˜ ÙË˜ ÌË ÏÂÎÙÈÎ‹˜ Û˘-ÌÂÚÈÊÔÚ¿˜ ÙÈ˜ ÔÔ›Â˜ Û˘ÓÔ„›˙Ô˘ÌÂ ÛÂ ‰‡Ô ‚·ÛÈÎ¤˜ Î·-ÙËÁÔÚ›Â˜: (1) ÛÙËÓ ·˘ÙÔ·ÚÔ˘Û›·ÛË ÙÔ˘ ·ÙfiÌÔ˘, ‰ËÏ·‰‹:

ñ ÛÙËÓ ¤ÎÊÚ·ÛË ÙˆÓ Ì·ÙÈÒÓñ ÛÙÈ˜ ÂÎÊÚ¿ÛÂÈ˜ ÙÔ˘ ÚÔÛÒÔ˘ñ ÛÙË Ê˘ÛÈÎ‹ ÂÌÊ¿ÓÈÛË ÙÔ˘ ·ÙfiÌÔ˘ñ ÛÙË ÛÙ¿ÛË ÙÔ˘ ÛÒÌ·ÙÔ˜ñ ÛÙÈ˜ ı¤ÛÂÈ˜/ Î·ÙÂ˘ı‡ÓÛÂÈ˜ Ô˘ ·›ÚÓÂÈ ÙÔ ÛÒÌ·

ÛÙÔ ¯ÒÚÔñ ÛÙËÓ ¤Ó‰˘ÛËñ ÛÙÈ˜ ÎÈÓ‹ÛÂÈ˜ ÙˆÓ Î¿Ùˆ ¿ÎÚˆÓ Î·È ÛÙÈ˜ ı¤ÛÂÈ˜ Ô˘

·›ÚÓÔ˘Ó Ù· fi‰È·ñ ÛÙÈ˜ ̄ ÂÈÚÔÓÔÌ›Â˜ Î·È ÛÙË ̄ Ú‹ÛË ÙË˜ ̄ ÂÈÚ·„›·˜, ÙÔ˘

¯·ÈÚÂÙÈÛÌÔ‡ñ ÛÙÔ ¿ÁÁÈÁÌ· (·ÙÈÎ‹ ÂÈÎÔÈÓˆÓ›·)ñ ÛÙË ¯Ú‹ÛË ÙÔ˘ ¯ÚfiÓÔ˘ Î·È ÙÔ˘ ¯ÒÚÔ˘ñ ÛÙËÓ ÂÁÁ‡ÙËÙ· Î·Ù¿ ÙË ‰È¿ÚÎÂÈ· ÙË˜ ÂÈÎÔÈÓˆÓ›·˜ñ ÛÙÔ ¯ÂÈÚÈÛÌfi ·ÓÙÈÎÂÈÌ¤ÓˆÓÎ·È

(2) ÛÙË Û˘ÓÔ‰Â›· Î·È ˘ÔÛÙ‹ÚÈÍË ÙË˜ ÔÌÈÏ›·˜ ÌÂ ÌË ÏÂ-ÎÙÈÎ¿ ÛÙÔÈ¯Â›· (Ë ·Ú·ÁÏˆÛÛÈÎ‹ ÂÈÎÔÈÓˆÓ›·), ‰ËÏ·‰‹:

ñ ÛÙÈ˜ ÎÈÓ‹ÛÂÈ˜ ÙÔ˘ ÎÂÊ·ÏÈÔ‡ñ ÛÙÔ ÔÛÔÛÙfi ÙÔ˘ ÏfiÁÔ˘ñ ÛÙË ‰È¿ÚÎÂÈ· ÙÔ˘ ¯ÚfiÓÔ˘ ÔÌÈÏ›·˜ ñ ÛÙÔ Ï‹ıÔ˜ Î·È ÙË Û˘¯ÓfiÙËÙ· ÙˆÓ ·‡ÛÂˆÓ ÛÙÔ

ÏfiÁÔ Î·È ÛÙË ÛÈˆ‹ñ ÛÙÔ Ú˘ıÌfi ÙË˜ ·Ó·ÓÔ‹˜ñ ÛÙÈ˜ ‰È·Ù·Ú·¯¤˜ ÙË˜ ÔÌÈÏ›·˜, ÙÔ˘˜ ‰ÈÛÙ·ÁÌÔ‡˜ Î·È

ÙÈ˜ ·ÚÂÌ‚ÔÏ¤˜ ñ ÛÙÈ˜ ÏÂÎÙÈÎ¤˜ Ó‡ÍÂÈ˜ ·ÌÂÛfiÙËÙ·˜ Î·È ÛÙË ¯Ú‹ÛË ‹-

¯ˆÓ, fiˆ˜ «ÌÌÌ», «···»,ñ ÛÙËÓ ÔÈfiÙËÙ· ÙË˜ ÊˆÓ‹˜ (Ô ÙfiÓÔ˜, Ë ¯ÚÔÈ¿, Ë ¤-

ÓÙ·ÛË, Ô Ú˘ıÌfi˜)ñ ÛÙËÓ ÚÔÊÔÚ¿, ÙË ‰È¿ÏÂÎÙÔ

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H ÈÛ¯‡Ô˘Û· ‰È¿ÎÚÈÛË ÛÙË ‚È‚ÏÈÔÁÚ·Ê›· ÛÂ ÏÂÎÙÈÎ‹ Î·È ÌËÏÂÎÙÈÎ‹ ÂÈÎÔÈÓˆÓ›· ·ÚÔ˘ÛÈ¿˙ÂÈ Î¿ÔÈ· ÚÔ‚Ï‹Ì·Ù·.¶ÔÏÏÔ› ÈÛÙÂ‡Ô˘Ó fiÙÈ Ë ÌË ÏÂÎÙÈÎ‹ ÂÈÎÔÈÓˆÓ›· ‰È·ÊÔÚÔ-ÔÈÂ›Ù·È ·fi ÙË ÏÂÎÙÈÎ‹ ÏfiÁˆ ¤ÏÏÂÈ„Ë˜ ÚÔÊÔÚÈÎÔ‡ Ïfi-ÁÔ˘. ŸÌˆ˜ ÙÔ ÏÂÎÙÈÎfi Î·È ÌË ÏÂÎÙÈÎfi Û‡ÛÙËÌ· ÏÂÈÙÔ˘ÚÁÂ›Ì·˙› ˆ˜ Ì¤ÚÔ˜ ÙË˜ ‰È·‰ÈÎ·Û›·˜ ÙË˜ ÂÈÎÔÈÓˆÓ›·˜. E›Ó·ÈˆÛÙfiÛÔ ·‰‡Ó·ÙÔ Ó· ‰È·¯ˆÚ›ÛÔ˘ÌÂ ÙË ÏÂÎÙÈÎ‹ Û˘ÌÂÚÈ-ÊÔÚ¿ ·fi ÙË ÌË ÏÂÎÙÈÎ‹. °È· ·Ú¿‰ÂÈÁÌ· ÔÈ ÎÈÓ‹ÛÂÈ˜ ÙˆÓ¯ÂÚÈÒÓ ÛÙÔ˘˜ ÎˆÊ¿Ï·ÏÔ˘˜ ·ÊÔÚÔ‡Ó ¯ÂÈÚÔÓÔÌ›Â˜ Ô˘ÂÚÓÔ‡Ó ÏÂÎÙÈÎ¿ ÌËÓ‡Ì·Ù·, ÂÓÒ fiÏÂ˜ ÔÈ ÊˆÓËÙÈÎ¤˜ ÂÎ-ÊÚ¿ÛÂÈ˜ ‰ÂÓ Â›Ó·È ÚÔÊÔÚÈÎfi˜ ÏfiÁÔ˜ (fiˆ˜ ÙÔ ÌÔ˘Ú-ÌÔ˘ÚËÙfi) Î·È ÌÔÚÂ› Ó· ÎÚ‡‚Ô˘Ó ı¤ÛÂÈ˜ Î·È Û˘Ó·ÈÛı‹Ì·-Ù·. T·˘Ùfi¯ÚÔÓ·, ÔÈ ÌË ÏÂÎÙÈÎ¤˜ ÂÎ‰ËÏÒÛÂÈ˜ ÙË˜ ·ÓıÚÒ-ÈÓË˜ Û˘ÌÂÚÈÊÔÚ¿˜ ÌÔÚÔ‡Ó Ó· ÂÚÌËÓÂ˘ıÔ‡Ó Ì¤Ûˆ ÏÂ-ÎÙÈÎÒÓ Û˘Ì‚fiÏˆÓ. O ‰È·¯ˆÚÈÛÌfi˜ ÙË˜ ÂÈÎÔÈÓˆÓ›·˜ ÛÂ‰‡Ô Û˘ÓÈÛÙÒÛÂ˜ ‹ Ë ¤ÌÊ·ÛË ÛÙË Ì›· Û˘ÓÈÛÙÒÛ· Î·Ù¿ ÙË‰È¿ÚÎÂÈ· ÙË˜ ‰È·‰ÈÎ·Û›·˜ ÙË˜ ÂÈÎÔÈÓˆÓ›·˜ ·Ê‹ÓÔ˘Ó ·¤Íˆ Î·È ¿ÏÏÂ˜ ÛËÌ·ÓÙÈÎ¤˜ ‰È·ÛÙ¿ÛÂÈ˜10, fiˆ˜:(1) ÙÈ˜ Û¯¤ÛÂÈ˜ ÙˆÓ ·Ú·¿Óˆ (ÏÂÎÙÈÎÒÓ Î·È ÌË ÏÂÎÙÈÎÒÓ)¯·Ú·ÎÙËÚÈÛÙÈÎÒÓ ÌÂÙ·Í‡ ÙÔ˘˜,(2) ÙÈ˜ Û¯¤ÛÂÈ˜ ÙË˜ fiÏË˜ Û˘ÌÂÚÈÊÔÚ¿˜ ÙˆÓ ·ÙfiÌˆÓ Ô˘ÂÈÎÔÈÓˆÓÔ‡Ó ÌÂ Ù· Û˘Ó·ÈÛı‹Ì·Ù· Î·È ÙËÓ ÚÔÛˆÈÎfiÙË-Ù¿ ÙÔ˘˜,(3) ÙÔ ÂÚÈ‚¿ÏÏÔÓ Î·È ÙÈ˜ È‰ÈfiÙËÙÂ˜ ÙˆÓ Î·Ù·ÛÙ¿ÛÂˆÓ fi-Ô˘ Ë ÂÈÎÔÈÓˆÓ›· Ú·ÁÌ·ÙÔÔÈÂ›Ù·È.XÚËÛÈÌÔÔÈÒÓÙ·˜ ¤Ó· Û‡ÛÙËÌ· Ù·ÍÈÓfiÌËÛË˜ Ô˘ ¯ˆÚ›-˙ÂÈ Ù· Ú¿ÁÌ·Ù· ÛÂ ‰‡Ô ‰È·ÎÚÈÙ¤˜ Î·ÙËÁÔÚ›Â˜ (ÏÂÎÙÈÎfi/ÌË ÏÂÎÙÈÎfi) ‰ÂÓ Ï·Ì‚¿ÓÔ˘ÌÂ ˘fi„Ë ·Ú¿ÁÔÓÙÂ˜ Ô˘‰ÂÓ Ê·›ÓÂÙ·È Ó· ÂÓÙ¿ÛÛÔÓÙ·È ÛÂ Î¿ÔÈ· ·fi ÙÈ˜ ‰‡Ô. K·-Ù¿ ÙË ‰È¿ÚÎÂÈ· ÙË˜ ·ÓıÚÒÈÓË˜ ÂÈÎÔÈÓˆÓ›·˜ ÔÏfiÎÏËÚÔÙÔ ÛÒÌ· ·Ú¤¯ÂÈ ÏËÚÔÊÔÚ›Â˜ Û¯ÂÙÈÎ¿ ÌÂ ÙË Û˘Ó·ÈÛıË-Ì·ÙÈÎ‹ Î·Ù¿ÛÙ·ÛË ÙÔ˘ ·ÙfiÌÔ˘ Î·È ÛËÌ·ÙÔ‰ÔÙÂ› ÙÈ˜ ÚÔ-ı¤ÛÂÈ˜ ÙÔ˘22. OÈ ÏËÚÔÊÔÚ›Â˜ ·˘Ù¤˜ ‰›ÓÔÓÙ·È ÙfiÛÔ ÏÂÎÙÈ-Î¿ fiÛÔ Î·È ÌË ÏÂÎÙÈÎ¿. ŸÏÔ ÙÔ ·ÓıÚÒÈÓÔ ÛÒÌ· Û˘ÏÏ·Ì-‚¿ÓÂÈ Î·È ·ÔÎˆ‰ÈÎÔÔÈÂ› ÏËÚÔÊÔÚ›Â˜ ·fi ÙÔ ÂÚÈ‚¿Ï-ÏÔÓ Î·È ÛÙË Û˘Ó¤¯ÂÈ· ÁÂÓÓ¿ ÏÂÎÙÈÎ¤˜ Î·È ÌË ÏÂÎÙÈÎ¤˜ ·-·ÓÙ‹ÛÂÈ˜. ø˜ ÂÎ ÙÔ‡ÙÔ˘ Ë ¤ÎÊÚ·ÛË ÙÔ˘ ÛÒÌ·ÙÔ˜ ·Ô-Î·Ï‡ÙÂÈ ÌÈ· ÈÔ ÛÙÂÓ‹ Û¯¤ÛË ÌÂÙ·Í‡ Û˘Ó·ÈÛıËÌ¿ÙˆÓÎ·È Û˘ÌÂÚÈÊÔÚ¿˜.H ÛˆÌ·ÙÈÎ‹ ¤ÎÊÚ·ÛË ‰ÂÓ Â›Ó·È ¤Ó· ÌÂÌÔÓˆÌ¤ÓÔ Ê·ÈÓfi-ÌÂÓÔ, ·ÏÏ¿ ÌÈ· ÔÏÈÛÙÈÎ‹ ÔÙÈÎ‹ ÙË˜ Û˘ÓÔÏÈÎ‹˜ ÂÈÎÔÈÓˆ-ÓÈ·Î‹˜ ‰ÈÂÚÁ·Û›·˜ Ì¤Ûˆ ÙË˜ ÔÔ›·˜ ÔÈ ·ÏÏËÏÂÈ‰ÚÒ-ÓÙÂ˜ ÌÔÚÔ‡Ó Ó· ÂÚÌËÓÂ‡ÛÔ˘Ó, Ó· Î·Ù·ÛÎÂ˘¿ÛÔ˘Ó Î·ÈÓ· ÌÂÙ·‰ÒÛÔ˘Ó ÓÔ‹Ì·Ù· ÌÂ ·ÔÙÂÏÂÛÌ·ÙÈÎfiÙËÙ·. ™ÙËÓÚ·ÁÌ·ÙÈÎfiÙËÙ· ÁÈ· Ó· ÂÚÌËÓÂ‡ÛÔ˘ÌÂ ¤Ó· Ì‹Ó˘Ì· Ï·Ì-‚¿ÓÔ˘ÌÂ ˘fi„Ë ÙËÓ fiÏË ÙË Û˘ÌÂÚÈÊÔÚ¿ ÙÔ˘ ·ÙfiÌÔ˘,¯ˆÚ›˜ Ó· Î¿ÓÔ˘ÌÂ Û˘ÓÂÈ‰ËÙ‹ ‰È¿ÎÚÈÛË fiÙÈ ·˘Ùfi ÙÔ Ì‹Ó˘-Ì· ÚÔ¤Ú¯ÂÙ·È ·fi ÙË ÏÂÎÙÈÎ‹ Î·È fi¯È ·fi ÙË ÌË ÏÂÎÙÈÎ‹Û˘ÌÂÚÈÊÔÚ¿, ÂÊfiÛÔÓ ·ÓÙÈÏ·Ì‚·ÓfiÌ·ÛÙÂ ÙÔ ¿ÙÔÌÔ ˆ˜Û‡ÓÔÏÔ Î·È fi¯È ˆ˜ Û˘ÏÏÔÁ‹ ¯·Ú·ÎÙËÚÈÛÙÈÎÒÓ. °È· ·Ú¿-‰ÂÈÁÌ·, fiÙ·Ó ¤Ó· ÏÂÎÙÈÎfi Ì‹Ó˘Ì· Â›Ó·È ·Û·Ê¤˜ ·Ó·˙Ë-ÙÔ‡ÌÂ ·Û˘ÓÂ›‰ËÙ· ÌË ÏÂÎÙÈÎ¿ ÌËÓ‡Ì·Ù· ÁÈ· Ó· ÂÚÌËÓÂ‡-ÛÔ˘ÌÂ ÙÔ ÙÈ ÂÈÒıËÎÂ. K·Ù¿ ÙË ‰È¿ÚÎÂÈ· Û˘ÓÔÌÈÏ›·˜ ÛÙÔÙËÏ¤ÊˆÓÔ ‰›ÓÔ˘ÌÂ ÂÚÈÛÛfiÙÂÚË ÚÔÛÔ¯‹ ÛÙ· ·Ú·-ÁÏˆÛÛÈÎ¿ ÛÙÔÈ¯Â›·, fiˆ˜ ÛÙËÓ ÚÔÛˆ‰›· (ÂÈÙÔÓÈÛÌfi˜,¯ÚÔÈ¿ ÙË˜ ÊˆÓ‹˜, ¤ÓÙ·ÛË, ‰‡Ó·ÌË, Ú˘ıÌfi˜, ·‡ÛÂÈ˜ÎÏ.), ÁÈ·Ù› Ù· ÎÈÓËÌ·ÙÈÎ¿ ÛÙÔÈ¯Â›· ÙÔ˘ ÏfiÁÔ˘ ·Ô˘ÛÈ¿-˙Ô˘Ó (ÔÈ ÎÈÓ‹ÛÂÈ˜ ÙÔ˘ ÚÔÛÒÔ˘ Î·È ÙˆÓ ¯ÂÚÈÒÓ, ÔÈ ı¤-ÛÂÈ˜ ÙÔ˘ ÛÒÌ·ÙÔ˜ Î.Ï.).

H ™HMA™IA TH™ A¶OTE§E™MATIKH™ E¶IKOINøNIA™™TH ™XE™H O¢ONTIATPOY-A™£ENH¶¤Ú· ·fi ÙÈ˜ ÎÏÈÓÈÎ¤˜ ‰ÂÍÈfiÙËÙÂ˜ ÙˆÓ Ô‰ÔÓÙÈ¿ÙÚˆÓ, Ë È-Î·ÓfiÙËÙ· Ó· ÂÈÎÔÈÓˆÓÔ‡Ó ·ÔÙÂÏÂÛÌ·ÙÈÎ¿ ÌÂ ÙÔ˘˜ ·-ÛıÂÓÂ›˜ Î·È Ó· ·ÔÎˆ‰ÈÎÔÔÈÔ‡Ó Ù· Û˘Ó·ÈÛı‹Ì·Ù¿ ÙÔ˘˜,Ó· Û˘ÁÎÂÓÙÚÒÓÔ˘Ó Û‡ÓÙÔÌ· ÙÈ˜ ÛˆÛÙ¤˜ ÏËÚÔÊÔÚ›Â˜,Ó· ‰Â›¯ÓÔ˘Ó ÂÓÛ˘Ó·›ÛıËÛË Î·È Â·ÁÁÂÏÌ·ÙÈÛÌfi ıÂˆÚÂ›-Ù·È Ï¤ÔÓ ̇ ˆÙÈÎ‹˜ ÛËÌ·Û›·˜23. ŒÚÂ˘ÓÂ˜ ·Ó·Ê¤ÚÔ˘Ó fiÙÈ Ë·ÔÙÂÏÂÛÌ·ÙÈÎ‹ ‰È·ÚÔÛˆÈÎ‹ ÂÈÎÔÈÓˆÓ›· ·˘Í¿ÓÂÈ ÙËÓÈÎ·ÓÔÔ›ËÛË ÙˆÓ ·ÛıÂÓÒÓ24,25, ‚ÔËı¿ÂÈ ÛÙË Û˘ÌÌfiÚÊˆ-Û‹ ÙÔ˘˜ ˆ˜ ÚÔ˜ ÙË ıÂÚ·Â›·, ÌÂÈÒÓÂÈ ÙÔ ¿Á¯Ô˜ ÙÔ˘˜26,27

Î·È ÙÔÓ Î›Ó‰˘ÓÔ Î·Ù·ÁÁÂÏÈÒÓ ÏfiÁˆ Î·Î‹˜ Ú·ÎÙÈÎ‹˜28,29.Ÿˆ˜ ·Ó·Ê¤ÚÔ˘Ó ÔÈ Young, Meterko Î·È Desai30 Ë ÈÎ·ÓÔ-Ô›ËÛË ÙˆÓ ·ÛıÂÓÒÓ Â›Ó·È Ï¤ÔÓ ¤Ó· ‚·ÛÈÎfi ÎÚÈÙ‹ÚÈÔ ÌÂÙÔ ÔÔ›Ô ·ÍÈÔÏÔÁÂ›Ù·È Ë ÔÈfiÙËÙ· ÙˆÓ ˘ËÚÂÛÈÒÓ ˘ÁÂ›-·˜.E›ÛË˜, ÏfiÁˆ ÙˆÓ ‰ËÌÔÁÚ·ÊÈÎÒÓ Î·È ÎÔÈÓˆÓÈÎÒÓ ·ÏÏ·-ÁÒÓ, Ô Û‡Á¯ÚÔÓÔ˜ Ô‰ÔÓÙ›·ÙÚÔ˜ ı· Ú¤ÂÈ Ó· Â›Ó·È ÛÂ ı¤-ÛË Ó· ÌÔÚÂ› Ó· ÂÈÎÔÈÓˆÓÂ› ·ÔÙÂÏÂÛÌ·ÙÈÎ¿ ÌÂ ·ÛıÂ-ÓÂ›˜ Ô˘ ÚÔ¤Ú¯ÔÓÙ·È ·fi ‰È¿ÊÔÚ· Ê˘ÏÂÙÈÎ¿, ÂıÓÈÎ¿,ÁÏˆÛÛÈÎ¿, ÎÔÈÓˆÓÈÎÔÔÈÎÔÓÔÌÈÎ¿ Î·È ÔÏÈÙÈÛÌÈÎ¿ ˘fi‚·-ıÚ·. OÈ ‰ÂÍÈfiÙËÙÂ˜ ·˘Ù¤˜ Â›Ó·È ··Ú·›ÙËÙÂ˜ ÁÈ· ÙËÓ ·-ÓÙÈÌÂÙÒÈÛË ÙˆÓ ·ÓÈÛÔÙ‹ÙˆÓ ÛÙË ÊÚÔÓÙ›‰· ÙË˜ ÛÙÔÌ·ÙÈ-Î‹˜ ˘ÁÂ›·˜31. B¤‚·È· Ë ÈÎ·ÓfiÙËÙ· ÙÔ˘ Ó· ÂÈÎÔÈÓˆÓÂ›˜ ·ÔÙÂÏÂÛÌ·ÙÈ-Î¿ ÌÂ ÙÔÓ ·ÛıÂÓ‹ ‰ÂÓ Â›Ó·È ¿ÓÙ· ‰˘Ó·Ù‹ ÂÂÈ‰‹ ÔÈ ÛÙfi-¯ÔÈ Ì·˜ ÌÔÚÂ› Ó· ‰È·Ê¤ÚÔ˘Ó ·fi ·˘ÙÔ‡˜ ÙˆÓ ·ÛıÂÓÒÓ‹ Ô Î·ı¤Ó·˜ Ó· ·ÓÙÈÏ·Ì‚¿ÓÂÙ·È ‰È·ÊÔÚÂÙÈÎ¿ ÙËÓ ÂÈÎÔÈ-ÓˆÓÈ·Î‹ Û¯¤ÛË Ô˘ ‰ËÌÈÔ˘ÚÁÂ›Ù·È. EÈÏ¤ÔÓ, Ë ÂÈÎÔÈ-ÓˆÓÈ·Î‹ ÈÎ·ÓfiÙËÙ· ÙÔ˘ Ô‰ÔÓÙÈ¿ÙÚÔ˘ ÂËÚÂ¿˙ÂÙ·È ·fi Ù·ÛÙÂÚÂfiÙ˘· Ô˘ ¤¯ÂÈ Û¯ÂÙÈÎ¿ ÌÂ ÙÔ˘˜ ·ÛıÂÓÂ›˜ Ô˘ ·Ó‹-ÎÔ˘Ó ÛÂ ÔÚÈÛÌ¤ÓÂ˜ ÔÌ¿‰Â˜ (¯. ËÏÈÎÈˆÌ¤ÓÔÈ, ·È‰È¿), ·-fi ÙÈ˜ ÚÒÙÂ˜ ÂÓÙ˘ÒÛÂÈ˜ ÁÈ· ÙÔÓ ·ÛıÂÓ‹ (Û¯ÔÏ·ÛÙÈÎfi˜,ÂÈÎÚÈÙÈÎfi˜, Û˘ÓÂÚÁ¿ÛÈÌÔ˜, ÌË Û˘ÓÂÚÁ¿ÛÈÌÔ˜ ÎÏ) ÔÈ Ô-Ô›Â˜ Î·ıÔÚ›˙Ô˘Ó Î·È ÙÈ˜ ÌÂÙ·ÁÂÓ¤ÛÙÂÚÂ˜ ·ÓÙÈÏ‹„ÂÈ˜ Î·ÈÂ›Ó·È ·ÓıÂÎÙÈÎ¤˜ ÛÙËÓ ·ÏÏ·Á‹, ·fi ÙËÓ ÂÈÏÂÎÙÈÎ‹ ·ÓÙ›-ÏË„Ë Û‡ÌÊˆÓ· ÌÂ ÙËÓ ÔÔ›· ‰›ÓÔ˘ÌÂ ÚÔÛÔ¯‹ ÛÙ·Ú¿ÁÌ·Ù· Ô˘ Â›Ó·È Û˘ÓÂ‹ ÌÂ ÙÈ˜ ‰ÈÎ¤˜ Ì·˜ ÂÌÂÈÚ›Â˜Î·È ·ÓËÛ˘¯›Â˜ Î.Ï. TÔ ˙ËÙÔ‡ÌÂÓÔ Â›Ó·È ÔÈ Ô‰ÔÓÙ›·ÙÚÔÈ, ÂÓÒ Â›Ó·È ÚÔÛ·Ó·-ÙÔÏÈÛÌ¤ÓÔÈ ÚÔ˜ ÙÔÓ ·ÛıÂÓ‹, ÙËÓ ›‰È· ÛÙÈÁÌ‹ Ó· ‰È·ÙË-ÚÔ‡Ó ÙËÓ ÈÎ·ÓfiÙËÙ· Ó· ÔÏÔÎÏËÚÒÓÔ˘Ó ÙÔ˘˜ ‰ÈÎÔ‡˜ ÙÔ˘˜ÛÙfi¯Ô˘˜, fiˆ˜ Ú¤ÂÈ Ó· Û˘Ì‚·›ÓÂÈ ÛÙËÓ ·ÓıÚÒÈÓË Â-ÈÎÔÈÓˆÓ›· Î·È Û˘ÌÂÚÈÊÔÚ¿32. O ÚÔÛ·Ó·ÙÔÏÈÛÌfi˜ÚÔ˜ ÙÔÓ ¿ÏÏÔ ·Ô‰ÂÈÎÓ‡ÂÙ·È ‰Â›¯ÓÔÓÙ·˜ ÂÓÛ˘Ó·›ÛıË-ÛË, ˘ÔÛÙ‹ÚÈÍË Î·È ¯·Ï·ÚfiÙËÙ· Î·Ù¿ ÙË ‰È¿ÚÎÂÈ· ÙË˜·ÏÏËÏÂ›‰Ú·ÛË˜, ÚÔÛ·ÚÌfi˙ÔÓÙ·˜ Ù·˘Ùfi¯ÚÔÓ· ÙË Û˘-ÌÂÚÈÊÔÚ¿ ·Ó·ÏfiÁˆ˜ ÙˆÓ ÂÚÈÛÙ¿ÛÂˆÓ. A˘Ùfi Â›Ó·È ÙÔ·ÔÙ¤ÏÂÛÌ· ÌÈ·˜ ·ÔÙÂÏÂÛÌ·ÙÈÎ‹˜ ÂÈÎÔÈÓˆÓ›·˜ ÌÂÙ·Í‡Ô‰ÔÓÙÈ¿ÙÚÔ˘ Î·È ·ÛıÂÓ‹.

OI I¢IAITEPOTHTE™ ™THN E¶IKOINøNIA ME TON H§IKIøMENO O¢ONTIATPIKO A™£ENHOÈ Î·ÓfiÓÂ˜ ÂÈÎÔÈÓˆÓ›·˜ ÔÈÎ›ÏÔ˘Ó ·Ó¿ÏÔÁ· ÌÂ ÙËÓ ËÏÈ-Î›·, ÙÔ Ê‡ÏÔ, ÙÔÓ ÔÏÈÙÈÛÌfi ‹ ÙÈ˜ ‰È·ÊÔÚÂÙÈÎ¤˜ ·ÓÙÈÏ‹-„ÂÈ˜ Ô˘ ÂÈÎÚ·ÙÔ‡Ó ÌÂÙ·Í‡ ÙˆÓ ÁÂÓÂÒÓ33. H Ê˘ÛÈÔÏÔÁÈÎ‹ Á‹Ú·ÓÛË Î·È Î˘Ú›ˆ˜ Ë ÓfiÛÔ˜ Ô˘ Û˘¯Ó¿Û˘ÓÔ‰Â‡ÂÈ ÙÔ Á‹Ú·˜ ÂËÚÂ¿˙Ô˘Ó ÙÔÓ ÙÚfiÔ Î·È ÙËÓ ·Ô-

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ÙÂÏÂÛÌ·ÙÈÎfiÙËÙ· ÙË˜ ÂÈÎÔÈÓˆÓ›·˜ ÙÔ˘ ËÏÈÎÈˆÌ¤ÓÔ˘ ÌÂ ÙÔÂÚÈ‚¿ÏÏÔÓ ÙÔ˘. Y¿Ú¯Ô˘Ó ˆÛÙfiÛÔ Î¿ÔÈÂ˜ Ú·ÎÙÈÎ¤˜Ô˘ ‰ÈÂ˘ÎÔÏ‡ÓÔ˘Ó ·˘Ù‹ ÙËÓ ÂÈÎÔÈÓˆÓ›·3,5,6 (¶›Ó. 1). AÓ Î·È ÔÈ ËÏÈÎÈˆÌ¤ÓÔÈ ·ÛıÂÓÂ›˜ ·ÚÔ˘ÛÈ¿˙Ô˘Ó Î¿ÔÈ·ÎÔÈÓ¿ ¯·Ú·ÎÙËÚÈÛÙÈÎ¿, Ë ÌÂÁ¿ÏË ‚ÈÔÏÔÁÈÎ‹ ÌÂÙ·‚ÏËÙfi-ÙËÙ·, ‰ËÏ·‰‹ ÔÈ ÛËÌ·ÓÙÈÎ¤˜ ‰È·ÊÔÚÔÔÈ‹ÛÂÈ˜ ÌÂÙ·Í‡ÙˆÓ ‰È·ÊfiÚˆÓ ·ÙfiÌˆÓ, ‰ÂÓ ı· Ú¤ÂÈ Ó· Ì·˜ ·Ú·Û‡ÚÂÈÛÂ ÛÙÂÚÂfiÙ˘·. Afi ÙËÓ ÚÒÙË Â·Ê‹ ı· Ú¤ÂÈ Ó· ·ÓÙÈÏËÊıÔ‡ÌÂ ÙË

‰È·ÓÔËÙÈÎ‹ Î·Ù¿ÛÙ·ÛË ÙÔ˘ ·ÛıÂÓ‹, ·Ó Î·È ‰ÂÓ Â›Ó·È ¿-ÓÙ· Â‡ÎÔÏÔ Ó· Î·Ù·ÁÚ¿„ÂÈ Î·ÓÂ›˜ ÙËÓ Èı·Ó‹ ÂÏ·ÊÚ¿Û‡Á¯˘ÛË. ™˘¯Ó¿ ÛÙË Û˘˙‹ÙËÛË ·ÚÂÌ‚·›ÓÔ˘Ó ÔÈ ÊÚÔÓÙÈ-ÛÙ¤˜ (¯ Û˘ÁÁÂÓÂ›˜) ÔÈ ÔÔ›ÔÈ ··ÓÙÔ‡Ó ·ÓÙ› ÁÈ· ÙÔÓ ›‰ÈÔÙÔÓ ·ÛıÂÓ‹ Î·È ¯ÚÂÈ¿˙ÔÓÙ·È Û¯ÂÙÈÎfi ÂÈÎÔÈÓˆÓÈ·Îfi ¯ÂÈÚÈ-ÛÌfi ·fi ÙÔÓ Ô‰ÔÓÙ›·ÙÚÔ.Afi ÙËÓ ·Ú¯ÈÎ‹ Û˘˙‹ÙËÛË Ú¤ÂÈ Â›ÛË˜ Ó· Á›ÓÂÈ ·ÓÙÈÏË-Ùfi Î¿ÔÈÔ Èı·Ófi Úfi‚ÏËÌ· ÛÙËÓ ·ÎÔ‹, Ô˘ Û˘¯Ó¿ Â-ÎÏ·Ì‚¿ÓÂÙ·È ̂ ˜ ‰È·ÓÔËÙÈÎfi Úfi‚ÏËÌ·. AÓ Ô ËÏÈÎÈˆÌ¤ÓÔ˜‰ÂÓ Ì·˜ ·ÎÔ‡ÂÈ Î·È ‰ÂÓ Ì·˜ ··ÓÙ¿, ·˘Ùfi ÂÚÈÏ¤ÎÂÈ ÙËÓÎÏÈÓÈÎ‹ ÙÔ˘ ÂÈÎfiÓ·. O ËÏÈÎÈˆÌ¤ÓÔ˜ ·ÚÔ˘ÛÈ¿˙ÂÈ Û˘¯Ó¿ ·-‰˘Ó·Ì›· Ó· ·ÓÙÈÏËÊıÂ› ˘„ËÏ¤˜ Û˘¯ÓfiÙËÙÂ˜, ‰˘ÛÎÔÏÂ‡Â-Ù·È Ó· ·ÓÙÈÏËÊıÂ› ÙË Ê˘ÛÈÔÏÔÁÈÎ‹ ÔÌÈÏ›· Î·È Â·ÎfiÏÔ˘ı·ÙÈ˜ ÂÚˆÙ‹ÛÂÈ˜ ‹ ÙÈ˜ ··ÓÙ‹ÛÂÈ˜ Î·È Ô‰ËÁ›Â˜ ÙÔ˘ Ô‰ÔÓÙÈ¿-ÙÚÔ˘3,5,6. AÓÙ›ıÂÙ· ÂÓÈÛ¯‡ÂÙ·È Ô ıfiÚ˘‚Ô˜ ·fi ÙÔ ÂÚÈ‚¿Ï-ÏÔÓ. ¶ÚÔÙ¿ÛÂÈ˜ ÁÈ· ÈÎ·ÓÔÔÈËÙÈÎ‹ ÂÈÎÔÈÓˆÓ›· ÌÂ ÙÔÓ ·-ÛıÂÓ‹ ÌÂ ÚÔ‚Ï‹Ì·Ù· ·ÎÔ‹˜ Î·Ù·ÁÚ¿ÊÔÓÙ·È ÛÙÔÓ ¶›Ó·-Î· 23,5,6.O ËÏÈÎÈˆÌ¤ÓÔ˜ Û˘Ó‹ıˆ˜ ‰ÂÓ ‚Ï¤ÂÈ Î·Ï¿. ™ÎfiÈÌÔ Â›Ó·ÈÓ· ˙ËÙ¿ÌÂ Ó· ÊÔÚ¤ÛÂÈ Ù· Á˘·ÏÈ¿ ÙÔ˘ Î·È Ó· ÂÈ‰ÈÒÎÔ˘ÌÂÓ· Â›Ó·È Î·Ïfi˜ Ô ÊˆÙÈÛÌfi˜ ÙÔ˘ ÂÚÈ‚¿ÏÏÔÓÙÔ˜. OÈ ÂÓ¤Ú-ÁÂÈÂ˜ ·˘Ù¤˜ ı· ÙÔÓ ‚ÔËı‹ÛÔ˘Ó Ó· ‚Ï¤ÂÈ Î·Ï‡ÙÂÚ· ÙÈ˜ÎÈÓ‹ÛÂÈ˜ ÙˆÓ ¯ÂÈÏ¤ˆÓ Ì·˜ Î·È ÙÈ˜ ÂÎÊÚ¿ÛÂÈ˜ ÙÔ˘ ÚÔÛÒ-Ô˘ Ì·˜, È‰È·›ÙÂÚ· ·Ó ¿Û¯ÂÈ Î·È ·fi ‚·ÚËÎÔ˝·. OÈ ÁÚ·-Ù¤˜ Ô‰ËÁ›Â˜ Ô˘ ı· ‰ÒÛÔ˘ÌÂ ı· Ú¤ÂÈ Ó· ÂÚÈÏ·Ì‚¿-ÓÔ˘Ó ÌÂÁ¿ÏÔ˘ ÌÂÁ¤ıÔ˘˜ ÁÚ·ÌÌ·ÙÔÛÂÈÚ¿ ÛÂ ¤ÓÙÔÓË ·ÓÙ›-ıÂÛË ÌÂ ÙÔ ÊfiÓÙÔ6. E›Ó·È Â›ÛË˜ Èı·ÓfiÓ Ó· ÌËÓ ÌÔÚ¤-ÛÔ˘ÌÂ Ó· ¯ÚËÛÈÌÔÔÈ‹ÛÔ˘ÌÂ ÙÔÓ Î·ıÚ¤ÊÙË ÁÈ· Ó· ‰ÂÈ Ô·ÛıÂÓ‹˜ ÙÈ˜ Î·ÈÓÔ‡ÚÁÈÂ˜ ÙÔ˘ Ô‰ÔÓÙÔÛÙÔÈ¯›Â˜ ‹ Î¿ÔÈ· Â-›‰ÂÈÍË ÛÙÔÌ·ÙÈÎ‹˜ ˘ÁÈÂÈÓ‹˜ ÛÙÔ ÛÙfiÌ· ÙÔ˘, ÂÊfiÛÔÓ ‰ÂÓÌÔÚÂ› Ó· ‰È·ÎÚ›ÓÂÈ ÏÂÙÔÌ¤ÚÂÈÂ˜. MÂ Â˘·ÈÛıËÛ›· Â›Ó·È ÛÎfiÈÌÔ Ó· ÚˆÙ¿ÌÂ -·Ó ‰ÂÓ ÙÔ ¤-¯Ô˘ÌÂ ‹‰Ë ·ÓÙÈÏËÊıÂ› ·fi ÙË ÁÂÓÈÎfiÙÂÚË ÂÈÎÔÈÓˆÓÈ·Î‹Û˘ÌÂÚÈÊÔÚ¿ ÙÔ˘- ·Ó Ô ·ÛıÂÓ‹˜ ÁÓˆÚ›˙ÂÈ ·Ó¿ÁÓˆÛË

26


¶›Ó·Î·˜ 1

¶POTA™EI™ °IA A¶OTE§E™MATIKH E¶IKOINøNIA ME TON H§IKIøMENO A™£ENH

EÏ¤Á¯Ô˘ÌÂ ·Ó Ô ·ÛıÂÓ‹˜ ·ÎÔ‡ÂÈ Î·È ‚Ï¤ÂÈ Î·Ï¿

EÏ¤Á¯Ô˘ÌÂ ÙË ‰È·ÓÔËÙÈÎ‹ Î·Ù¿ÛÙ·ÛË ÙÔ˘ ·ÛıÂÓ‹

¢È·ı¤ÙÔ˘ÌÂ ÂÚÈÛÛfiÙÂÚÔ ¯ÚfiÓÔ ÁÈ· ÙË Û˘˙‹ÙËÛË

ºÚÔÓÙ›˙Ô˘ÌÂ ÁÈ· Î·Ïfi ÊˆÙÈÛÌfi ÒÛÙÂ Ó· ‚Ï¤ÂÈ Î·ı·-Ú¿ ÙÔ ÚfiÛˆfi Ì·˜

¶ÂÚÈÔÚ›˙Ô˘ÌÂ ÙÔ˘˜ ıÔÚ‡‚Ô˘˜ ÙÔ˘ ÂÚÈ‚¿ÏÏÔÓÙÔ˜(¯. ÌÔ˘ÛÈÎ‹, ÙÚÔ¯fi˜)

™ÙÂÎfiÌ·ÛÙÂ ·Ú¿ÏÏËÏ· ÌÂ ÙÔ ÛÒÌ· ÙÔ˘ ·ÛıÂÓ‹

EÈ‰ÈÒÎÔ˘ÌÂ ¿ÌÂÛË ÔÙÈÎ‹ Â·Ê‹ Î·È ÂÛÙÈ¿˙Ô˘ÌÂ ÙÔ‚Ï¤ÌÌ· Ì·˜ ÛÙÔÓ ·ÛıÂÓ‹

AÔÊÂ‡ÁÔ˘ÌÂ ÙË Û˘˙‹ÙËÛË ÊÔÚÒÓÙ·˜ Ô‰ÔÓÙÈ·ÙÚÈÎ‹Ì¿ÛÎ· ‹ Ì¤ÓÔÓÙ·˜ Ì·ÎÚÈ¿ ·fi ÙÔÓ ·ÛıÂÓ‹

XÚËÛÈÌÔÔÈÔ‡ÌÂ ıÂÙÈÎ¤˜ ÂÎÊÚ¿ÛÂÈ˜ ÚÔÛÒÔ˘ (¯·-ÌfiÁÂÏÔ, ·Ó‡„ˆÛË ÊÚ˘‰ÈÒÓ) Î·È Î›ÓËÛË ÙË˜ ÎÂÊ·Ï‹˜‰Â›¯ÓÔÓÙ·˜ ÂÓ‰È·Ê¤ÚÔÓ Î·È Û˘ÌÊˆÓ›·

XÚËÛÈÌÔÔÈÔ‡ÌÂ ·Ï‹ Î·È Î·Ù·ÓÔËÙ‹ ÁÏÒÛÛ·

E·Ó·Ï·Ì‚¿ÓÔ˘ÌÂ ·ÚÎÂÙ¤˜ ÊÔÚ¤˜ ÙÈ˜ ÏËÚÔÊÔÚ›Â˜Î·È ÂÏ¤Á¯Ô˘ÌÂ ·Ó ¤ÁÈÓ·Ó Î·Ù·ÓÔËÙ¤˜

K¿ÓÔ˘ÌÂ ÂÚˆÙ‹ÛÂÈ˜ Î·È ˙ËÙÔ‡ÌÂ ‰ÈÂ˘ÎÚÈÓ‹ÛÂÈ˜

EÓı·ÚÚ‡ÓÔ˘ÌÂ ÙÔÓ ·ÛıÂÓ‹ Ó· Û˘ÓÂ¯›ÛÂÈ Ó· ÌÈÏ¿ÂÈ¯ˆÚ›˜ Ó· ÙÔÓ ‰È·ÎfiÙÔ˘ÌÂ. AÓ ·Ú·Û˘ÚıÂ› ÛÂ ÂÎÙfi˜ı¤Ì·ÙÔ˜ ÏËÚÔÊÔÚ›Â˜, Â˘ÁÂÓÈÎ¿ Â·Ó·Ê¤ÚÔ˘ÌÂ ÙËÛ˘˙‹ÙËÛË ÛÙÔ ı¤Ì·

YÔÛÙËÚ›˙Ô˘ÌÂ ÙË Û˘˙‹ÙËÛË ·ÏÏ¿˙ÔÓÙ·˜ ÙÔÓ Ú˘ıÌfiÎ·È ÙÔÓ ÙfiÓÔ ÙË˜ ÊˆÓ‹˜ Î·È ¯ÚËÛÈÌÔÔÈÔ‡ÌÂ ˘ÔÛÙË-ÚÈÎÙÈÎ¤˜ ÂÎÊÚ¿ÛÂÈ˜ (¯. «ÌÌÌ» «ÔÔÔ»)

¢›ÓÔ˘ÌÂ ÙÈ˜ ÏËÚÔÊÔÚ›Â˜ ÌÂ ÔÏÏÔ‡˜ ÙÚfiÔ˘˜ (ÁÚ·-Ù¿, ÚÔÊÔÚÈÎ¿)

OÈ ÁÚ·Ù¤˜ Ô‰ËÁ›Â˜ ı· Ú¤ÂÈ Ó· ÂÚÈÏ·Ì‚¿ÓÔ˘Ó ÌÂ-Á¿ÏÔ˘ ÌÂÁ¤ıÔ˘˜ ÁÚ¿ÌÌ·Ù· ÛÂ ¤ÓÙÔÓË ¯ÚˆÌ·ÙÈÎ‹ ·-ÓÙ›ıÂÛË ÌÂ ÙÔ ÊfiÓÙÔ

¢›ÓÔ˘ÌÂ ÙÈ˜ ÏËÚÔÊÔÚ›Â˜ ‹ ÙÈ˜ Ô‰ËÁ›Â˜ ÛÙ·‰È·Î¿ Î·ÈÛÂ ‰È·‰Ô¯ÈÎ¤˜ Û˘ÓÂ‰Ú›Â˜, ·Ó Â›Ó·È ÔÏÏ¤˜ ÛÂ fiÁÎÔ

¢›ÓÔ˘ÌÂ ÙÈ˜ Ô‰ËÁ›Â˜ ÌÂ ‚¿ÛË ÙË ¯ÚÔÓÈÎ‹ ÛÂÈÚ¿ ÂÍ¤ÏÈ-ÍË˜ ÙÔ˘˜

EÏ¤Á¯Ô˘ÌÂ ÙËÓ ÚÔËÁÔ‡ÌÂÓË ÂÌÂÈÚ›· ÙÔ˘ ·fi ÙÔÓÔ‰ÔÓÙ›·ÙÚÔ Î·È ·ÍÈÔÏÔÁÔ‡ÌÂ Ò˜ ÂËÚÂ¿˙ÂÈ ÙË ÛËÌÂ-ÚÈÓ‹ ÙÔ˘ ÛÙ¿ÛË Î·È Û˘ÌÂÚÈÊÔÚ¿

¶›Ó·Î·˜ 2

¶POTA™EI™ °IA A¶OTE§E™MATIKHE¶IKOINøNIA ME TON H§IKIøMENO A™£ENH

ME BAPHKO´A

Y„ÒÓÔ˘ÌÂ ÂÏ·ÊÚ¿ ÙËÓ ¤ÓÙ·ÛË ÙË˜ ÊˆÓ‹˜ ¯ˆÚ›˜ fi-Ìˆ˜ Ó· ÊˆÓ¿˙Ô˘ÌÂ

MÈÏ¿ÌÂ ·ÚÁ¿ Î·È Î·ı·Ú¿

TÔ ÚfiÛˆfi Ì·˜ Ú¤ÂÈ Ó· Â›Ó·È ÛÙÔ ›‰ÈÔ Â›Â‰Ô Î·ÈÓ· ·ÓÙÈÎÚ›˙ÂÈ ÙÔ ÚfiÛˆÔ ÙÔ˘ ·ÛıÂÓ‹

¢ÂÓ Ú¤ÂÈ Ó· ÎÚ‡‚ÂÙ·È ÙÔ ÛÙfiÌ· Ì·˜ (¯. ÌÂ Ì¿ÛÎ·)

ºÚÔÓÙ›˙Ô˘ÌÂ ÁÈ· Î·Ïfi ÊˆÙÈÛÌfi ÙÔ˘ ¯ÒÚÔ˘

M¤ÓÔ˘ÌÂ ÛÂ ·fiÛÙ·ÛË Ì¤¯ÚÈ 1 Ì¤ÙÚÔ ·fi ÙÔÓ ·ÛıÂÓ‹

K·ÙÂ˘ı‡ÓÔ˘ÌÂ ÙËÓ ÔÌÈÏ›· Ì·˜ ÚÔ˜ ÙÔ ·˘Ù› Ô˘ ·ÎÔ‡-ÂÈ Î·Ï‡ÙÂÚ·

K·Ù·ÚÁÔ‡ÌÂ ÙÔ˘˜ ıÔÚ‡‚Ô˘˜ ÂÚÈ‚¿ÏÏÔÓÙÔ˜ (¯.ÌÔ˘ÛÈÎ‹, ÙËÏÂfiÚ·ÛË, ÙÚÔ¯fi˜ Î.Ï.)

AÓ Ô ·ÛıÂÓ‹˜ ÊÔÚ¿ ·ÎÔ˘ÛÙÈÎfi ‚·ÚËÎÔ˝·˜ ‚Â‚·ÈˆÓfi-Ì·ÛÙÂ fiÙÈ Î·Ù¿ ÙË Û˘˙‹ÙËÛË Â›Ó·È ÂÓÂÚÁÔÔÈËÌ¤ÓÔ

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ÁÈ·Ù› ·ÎfiÌ· Î·È Û‹ÌÂÚ· ÔÏÏÔ› ËÏÈÎÈˆÌ¤ÓÔÈ Î·È, Î˘Ú›ˆ˜Á˘Ó·›ÎÂ˜, ‰ÂÓ ÁÓˆÚ›˙Ô˘Ó ÁÚ·Ê‹ Î·È ·Ó¿ÁÓˆÛË.¶Ú¤ÂÈ Ó· ‰È·ı¤ÙÂÈ Î¿ÔÈÔ˜ ·ÚÎÂÙfi ̄ ÚfiÓÔ Î·Ù¿ ÙË Û˘ÓÂ-‰Ú›· ÌÂ ¤Ó·Ó ËÏÈÎÈˆÌ¤ÓÔ, ÙfiÛÔ ÁÈ· Ó· ÙÔÓ ·ÎÔ‡ÛÂÈ fiÛÔÎ·È ÁÈ· Ó· ÂÍËÁ‹ÛÂÈ ÙÔ Û¯¤‰ÈÔ ıÂÚ·Â›·˜, Ó· ‰ÒÛÂÈ Ô‰Ë-Á›Â˜ Î·È Ó· ··ÓÙ‹ÛÂÈ ÛÂ ÂÚˆÙ‹ÛÂÈ˜ Ô˘ Û˘¯Ó¿ Â·Ó·-Ï·Ì‚¿ÓÔÓÙ·È. OÈ ËÏÈÎÈˆÌ¤ÓÔÈ ·Ú¤ÛÎÔÓÙ·È Ó· ÌÈÏÔ‡Ó ÁÈ·ÙÔ ·ÚÂÏıfiÓ Î·È Ó· ‰ÈËÁÔ‡ÓÙ·È ı¤Ì·Ù· ¿Û¯ÂÙ· ÌÂ ÙÔ Ïfi-ÁÔ ÁÈ· ÙÔÓ ÔÔ›Ô ÚÔÛ‹Ïı·Ó ÛÙÔ È·ÙÚÂ›Ô (¯. ÁÈ· Ù· ·È-‰È¿ ÙÔ˘˜ ‹ ÁÈ· ·Ï·ÈfiÙÂÚÂ˜ ÂÌÂÈÚ›Â˜ ÙÔ˘˜). XÚÂÈ¿˙ÂÙ·ÈÈ‰È·›ÙÂÚË Â˘·ÈÛıËÛ›· Î·È ÚÔÛÔ¯‹ ÁÈ· Ó· ÙÔ˘˜ ‰È·Îfi„ÂÈÎ·ÓÂ›˜ Î·È Ó· ÂÈÛÙÚ¤„ÂÈ ÛÙÔ ı¤Ì· ÙË˜ Û˘˙‹ÙËÛË˜ ̄ ˆÚ›˜Ó· ÙÔ˘˜ ÚÔÛ‚¿ÏÏÂÈ. H ÛˆÌ·ÙÈÎ‹ ¤ÎÊÚ·ÛË, fiˆ˜ ÚÔÛ‰ÈÔÚ›ÛÙËÎÂ ÚÔËÁÔ‡-ÌÂÓ·, ·ÔÎÙ¿ È‰È·›ÙÂÚË ÛËÌ·Û›· ÁÈ· ÙÔÓ ËÏÈÎÈˆÌ¤ÓÔ Ô˘ÌÂÁ¿ÏˆÛÂ ÛÂ ÂÔ¯¤˜ Î·È ÛÂ ÂÚÈ‚¿ÏÏÔÓÙ· fiÔ˘ Ë ¤Î-ÊÚ·ÛË Û˘Ó·ÈÛıËÌ¿ÙˆÓ ‰ÂÓ ‹Ù·Ó ÎÔÈÓˆÓÈÎ¿ ÂÈÙÚÂÙ‹6

Î·È ¤ÙÛÈ ‰˘ÛÎÔÏÂ‡ÂÙ·È Ó· ÂÈÎÔÈÓˆÓ‹ÛÂÈ ÏÂÎÙÈÎ¿ ÙÔ ¿Á-¯Ô˜, ÙÔ Êfi‚Ô, ÙËÓ ·ÁˆÓ›· ‹ Ù· ÔÈÎÔÓÔÌÈÎ¿ ÙÔ˘ ÚÔ‚Ï‹-Ì·Ù·. E›ÛË˜, Ë ÛˆÌ·ÙÈÎ‹ ¤ÎÊÚ·ÛË ‚ÔËı¿ Ó· ·ÓÙÈÏË-ÊıÔ‡ÌÂ Èı·Ó¿ ÚÔ‚Ï‹Ì·Ù· ̆ ÁÂ›·˜ ‹ ÙËÓ „˘¯ÈÎ‹ ¤ÓÙ·ÛËÙÔ˘ ·ÛıÂÓ‹. °È· ·Ú¿‰ÂÈÁÌ·, ÔÏÏ¤˜ ÊÔÚ¤˜ Ë ÚÒÙË¯ÂÈÚ·„›· ˘Ô‰ËÏÒÓÂÈ ÙËÓ Î·Ù¿ÛÙ·ÛË ÙÔ˘ ·ÛıÂÓ‹. MÈ·¯ÂÈÚ·„›· Ô˘ Â›Ó·È «ÛıÂÓ·Ú‹» Î·È ÎÚ·Ù¿ ÔÏ‡, Û˘¯Ó¿ ˘-Ô‰ËÏÒÓÂÈ ¤Ó·Ó ÊÔ‚ÈÛÌ¤ÓÔ ·ÛıÂÓ‹, ÂÓÒ Ë ¿ÚÓËÛË ÙË˜¯ÂÈÚ·„›·˜ ‰ËÏÒÓÂÈ Èı·Ó¿ ¤Ó·Ó ·ÛıÂÓ‹ ÛÂ Û‡Á¯˘ÛË ‹ ÌÂ¿ÓÔÈ·3. AÓÙ›ÛÙÔÈ¯·, ÔÈ Î·Ù·ıÏÈÙÈÎÔ› ËÏÈÎÈˆÌ¤ÓÔÈ ÌÔÚÂ›Ó· ·ÔÊÂ‡ÁÔ˘Ó ÙË ‚ÏÂÌÌ·ÙÈÎ‹ Â·Ê‹3.OÈ ‰È·Ù·Ú·¯¤˜ ÛÙËÓ ÚfiÛÊ·ÙË ÌÓ‹ÌË Î·È ÛÙËÓ ÈÎ·ÓfiÙË-Ù· Ì¿ıËÛË˜ Î·È ÚÔÛ·ÚÌÔÁ‹˜ ÛÂ Î·ÈÓÔ‡ÚÁÈÂ˜ Î·Ù·ÛÙ¿-ÛÂÈ˜ ··ÈÙÔ‡Ó Â›ÛË˜ È‰È·›ÙÂÚË ·ÓÙÈÌÂÙÒÈÛË. E›Ó·È Ô-Ï‡ ÛËÌ·ÓÙÈÎfi˜ Ô ÙÚfiÔ˜ Ô˘ ‰›ÓÔÓÙ·È ÔÈ ÏËÚÔÊÔÚ›Â˜Î·È ÔÈ Ô‰ËÁ›Â˜ ÚÔÊÔÚÈÎ¿ ‹ ÁÚ·Ù¿ (¶›Ó. 1). OÈ Ô‰ËÁ›Â˜Ú¤ÂÈ Ó· Â›Ó·È ·Ï¤˜ Î·È Û‡ÓÙÔÌÂ˜ Î·È Ó· ‰›ÓÔÓÙ·È ÌÂ ÙË¯ÚÔÓÔÏÔÁÈÎ‹ ÙÔ˘˜ ÛÂÈÚ¿6. E›ÛË˜, Ú¤ÂÈ Ó· Â·Ó·Ï·Ì-‚¿ÓÔÓÙ·È Û˘¯Ó¿. AÓ ı· Ú¤ÂÈ Ó· ‰ÔıÔ‡Ó Ô‰ËÁ›Â˜ ÛÂÔÏÏ¿ Â›Â‰·, Î·Ïfi Â›Ó·È Ó· ‰›ÓÔÓÙ·È ÛÂ ‰È·‰Ô¯ÈÎ¤˜ Û˘-ÓÂ‰Ú›Â˜6: °È· ·Ú¿‰ÂÈÁÌ·, ÛÙËÓ ÚÒÙË Û˘ÓÂ‰Ú›· ‰›ÓÔ˘-ÌÂ Ô‰ËÁ›Â˜ ÁÈ· ÙËÓ ̆ ÁÈÂÈÓ‹ ÙˆÓ ‰ÔÓÙÈÒÓ, ÛÙË ‰Â‡ÙÂÚË ÁÈ·ÙËÓ ˘ÁÈÂÈÓ‹ ÙˆÓ Ô‰ÔÓÙÔÛÙÔÈ¯ÈÒÓ Î·È ÛÙËÓ ÙÚ›ÙË ÁÈ· ÙÈ˜ Â-·ÓÂÍÂÙ¿ÛÂÈ˜.H Â›‰Ú·ÛË Èı·Ó‹˜ ÓfiÛÔ˘ (¿ÓÔÈ·, ·ÁÁÂÈ·Î¿ ÂÁÎÂÊ·ÏÈ-Î¿ ÂÂÈÛfi‰È·, Î·Ù¿ıÏÈ„Ë Î.¿.) ÂÈ‚·Ú‡ÓÂÈ ÂÚ·ÈÙ¤Úˆ ÙËÓÂÈÎÔÈÓˆÓ›· ·ÏÏ¿ Î·ıÒ˜ ·˘Ùfi ·ÔÙÂÏÂ› ¤Ó· ÂÈ‰ÈÎfi Î·ÈÌÂÁ¿ÏÔ ÎÂÊ¿Ï·ÈÔ ‰ÂÓ ı· ·Ó·Ï˘ıÂ› ÛÙËÓ ·ÚÔ‡Û· ÂÚÁ·-Û›·. ™ÙÈ˜ ÂÚÈÙÒÛÂÈ˜ ·˘Ù¤˜ ÛËÌ·ÓÙÈÎfi ÚfiÏÔ ·›˙ÂÈ Ë Â-ÈÎÔÈÓˆÓÈ·Î‹ Ì·˜ Û¯¤ÛË ÌÂ ÙÔ˘˜ ÊÚÔÓÙÈÛÙ¤˜ (Û˘ÁÁÂÓÂ›˜,È·ÙÚÈÎfi ÚÔÛˆÈÎfi, ÓÔÛËÏÂ˘ÙÈÎfi ÚÔÛˆÈÎfi). H ‰È¿ÎÚÈÛË ·Ó¿ÌÂÛ· ÛÙËÓ ·ÓÙÈÎÂÈÌÂÓÈÎ‹ ·Ó¿ÁÎË ıÂÚ·-Â›·˜, fiˆ˜ ÙËÓ Î·Ù·ÁÚ¿ÊÂÈ Ô Ô‰ÔÓÙ›·ÙÚÔ˜, Î·È ÛÙËÓ ˘-ÔÎÂÈÌÂÓÈÎ‹ ·Ó¿ÁÎË Î·È ÚÔÛ‰ÔÎ›· ÙÔ˘ ·ÛıÂÓ‹ ÚÔÎ·-ÏÂ› ÂÌfi‰È· ÛÙËÓ ÂÈÎÔÈÓˆÓ›·. O Ô‰ÔÓÙ›·ÙÚÔ˜ ÌÔÚÂ› Ó·ıÂˆÚÂ› fiÙÈ ı· Ú¤ÂÈ Ó· Î·Ù·ÛÎÂ˘·ÛÙÂ› Î·ÈÓÔ‡ÚÁÈ· Ô‰Ô-ÓÙÔÛÙÔÈ¯›· ÛÙÔÓ ËÏÈÎÈˆÌ¤ÓÔ, ÂÎÂ›ÓÔ˜ fiÌˆ˜ Ó· Â›Ó·È ·fi-Ï˘Ù· Â˘¯·ÚÈÛÙËÌ¤ÓÔ˜ ÌÂ ÙËÓ ·ÏÈ¿ Î·È Ó· ÌËÓ ı¤ÏÂÈ Ó·ÙËÓ ·ÏÏ¿ÍÂÈ. O Ô‰ÔÓÙ›·ÙÚÔ˜ ı· Ú¤ÂÈ Ó· ·ÍÈÔÔÈ‹ÛÂÈÎ·Ù¿ÏÏËÏÂ˜ ÙÂ¯ÓÈÎ¤˜, ÎÏÈÓÈÎ¤˜ Î·È ÂÈÎÔÈÓˆÓÈ·Î¤˜, ÁÈ· Ó·Û˘ÁÎÂÚ¿ÛÂÈ ÙÈ˜ Î·Ù·ÛÙ¿ÛÂÈ˜.TÂÏÂÈÒÓÔÓÙ·˜, ı· ‹Ù·Ó ·Ú¿ÏÂÈ„Ë Ó· ÌËÓ ·Ó·ÊÂÚıÂ› fiÙÈ

ÔÈ ÂÈÎÔÈÓˆÓÈ·Î¤˜ ‰ÂÍÈfiÙËÙÂ˜ Î·È Ë ÎÚÈÙÈÎ‹ ÛÎ¤„Ë ‰ÂÓ ÌÂ-Ù·‚¿ÏÏÔÓÙ·È ÛÙÔÓ ˘ÁÈ‹ ËÏÈÎÈˆÌ¤ÓÔ, ·ÏÏ¿ ÂÓ›ÔÙÂ ‚ÂÏÙÈÒ-ÓÔÓÙ·È2 Î·È ÔÏÏ¤˜ ÊÔÚ¤˜ Ë Û˘˙‹ÙËÛË Ì·˙› ÙÔ˘˜ ÚÔ-ÛÊ¤ÚÂÈ ÌÂÁ¿ÏË ÈÎ·ÓÔÔ›ËÛË.

™YM¶EPA™MATAOÈ ÂÈÎÔÈÓˆÓÈ·Î¤˜ ‰ÂÍÈfiÙËÙÂ˜ Â›Ó·È ·Ó·ÁÎ·›Â˜ ÁÈ· ÙËÓ ·-ÔÙÂÏÂÛÌ·ÙÈÎ‹ ·ÏÏËÏÂ›‰Ú·ÛË ÙÔ˘ Ô‰ÔÓÙÈ¿ÙÚÔ˘ ÌÂ ÙÔÓ·ÛıÂÓ‹ ÙÔ˘. AÔÎÙÔ‡Ó È‰È·›ÙÂÚË ÛËÌ·Û›· fiÙ·Ó ·Ó·ÊÂ-ÚfiÌ·ÛÙÂ ÛÂ ËÏÈÎÈˆÌ¤ÓÔ˘˜ ·ÛıÂÓÂ›˜ Ô˘ ·ÚÔ˘ÛÈ¿˙Ô˘Ó·ÈÛıËÙËÚÈ·Î‹ ·ÔÛÙ¤ÚËÛË Î·È ‰È·Ù·Ú·¯¤˜ ÛÙË ÌÓ‹ÌË.O Ô‰ÔÓÙ›·ÙÚÔ˜ Î·Ïfi Â›Ó·È Ó· ÁÓˆÚ›˙ÂÈ Î·È Ó· ·ÍÈÔÔÈÂ›Î·Ù¿ÏÏËÏÂ˜ ÂÈÎÔÈÓˆÓÈ·Î¤˜ ÙÂ¯ÓÈÎ¤˜ Ô˘ ‚·Û›˙ÔÓÙ·ÈÛÙËÓ Îˆ‰ÈÎÔÔ›ËÛË Î·È ·ÔÎˆ‰ÈÎÔÔ›ËÛË ÙË˜ ÏÂÎÙÈÎ‹˜ÂÈÎÔÈÓˆÓ›·˜ Î·È ÙË˜ ÛˆÌ·ÙÈÎ‹˜ ¤ÎÊÚ·ÛË˜ ÙfiÛÔ ÙË˜ ‰È-Î‹˜ ÙÔ˘ fiÛÔ Î·È ÙÔ˘ ·ÛıÂÓ‹.

SUMMARY

Communication between the dentist and the older dental patient

Riga V., Kossioni A.


Communication skills are important for the social, personaland professional success. Communication is currentlydivided into verbal and nonverbal. Verbal behaviour isrelated to spoken or written speech, while non verbalbehaviour refers to all acts apart from speech. Howeverthose two forms of communication often coexist andinterrelate and cannot be separately viewed.Communication skills are necessary for the dentalprofessional, as they are related to increased patientsatisfaction, reduced anxiety and better compliance.According to the document on the profile andcompetences for the graduating European dentistapproved by the Association for Dental Education inEurope in 2009, the dentist must be competent tocommunicate effectively with patients, carers and withother health professionals involved in their care,irrespective of age, social and cultural background. Thedentist must have specific skills to communicate with theolder patient. Age affects visual and auditory function, whileforgetfulness is more common than in younger ages. Ittakes more time to interview and examine the older patientand more time to provide the necessary instructions. Anyinformation should better be provided in multiple ways,orally and written. The instructions must be short and clear.It is often necessary to repeat the instructions more thanonce. During the interview the dentist should stay close tothe patient in parallel body position establishing direct eyecontact. Any written instructions must be provided in largeprint to accommodate people with poor vision. When theolder patient suffers from deafness the dentist shouldspeak slowly and clear and raise the voice withoutshouting. The lighting must be adequate and the patient

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able to see the lip movement of the dentist. Backgroundnoises should be eliminated. The dentist must be able todecode the patients desires and expectations throughverbal and non verbal cues and appropriately adapt thetreatment planning.

Key words: Communication; bodily expression; aged; dentist

BIB§IO°PAºIA1. Cowpe J, Plasschaert A, Harzer W, Vinkka-Puhakka H,

Walmsley, AD: Profile and Competences for the GraduatingEuropean Dentist - update 2009. Eur J Dent Educ: OfficialJournal of the Association for Dental Education in Europe2010; 14(4): 193-202.

2. ¢ÔÓÙ¿˜ A™: °ËÚÈ·ÙÚÈÎ‹ - °ÂÓÈÎ¿ ÛÙÔÈ¯Â›·. ™Â: K·ÚÎ·˙‹˜ HX,¶ÔÏ‡˙ÒË˜ °§., ÂÎ‰. °ËÚÔ‰ÔÓÙÈ·ÙÚÈÎ‹ Î·È °Ó·ıÔÚÔÛˆÈÎ‹¶ÚÔÛıÂÙÈÎ‹. Aı‹Ó·. MÔÓÈÛ¤Ï. 1988:19-26.

3. Bennet GCJ, Ebrahim S: The Essentials of Healthcare onOld Age. 2nd ed. London. Edward Arnold. 1995.

4. X·Ù˙Ë·ÓÙˆÓ›Ô˘ I: H „˘¯ÔÎÈÓËÙÈÎ‹, „˘¯ÔÏÔÁÈÎ‹ Î·È „˘¯Ô·-ıÔÏÔÁÈÎ‹ ÂÈÎfiÓ· ÙÔ˘ Á‹Ú·ÙÔ˜. ™Â: XÚÈÛÙÔ‰Ô‡ÏÔ˘ °N, KÔ-ÓÙ·Í¿ÎË˜ B¶. H ÙÚ›ÙË ËÏÈÎ›·. Aı‹Ó·. B‹Ù·. 2000:179-194.

5. Barnes I, Seymour R, Smith D, Walls A: Management of theOld Patient. In: Barnes I, Walls A. Gerodontology. Oxford.Wright. 1994:51-55.

6. Kiyak HA: Communication in the Practitioner-Aged PatientRelationship. In: Holm-Pedersen P, Loe H, eds. Textbook ofGeriatric Dentistry. 2nd ed. Copenhagen. Munksgaard.1996:150-161.

7. Skeff KM, Stratos GA, Berman J: Educational Theory andTeaching Medical Interviewing. In: Lipkin M, Putman SM,Lazare A, eds. The Medical Interview: Clinical Care,Education, and Research. New York: Springer-Verlag.1995:379-387.

8. Knapp ML, Hall JA: Nonverbal Communication in HumanInteraction. 7th ed. Crawfordsville, IN. Thomson Learning.2002.

9. Rubin RB: Assessing Speaking and Listening Competenceat the College Level: The Communication CompetencyAssessment Instrument. Commun Educ 1982; 31(1):9-32.

10. Mehrabian A: Nonverbal Communication. Chicago. AldineAtherton. 1972.

11. Knapp ML: Nonverbal Communication in HumanInteraction. New York. Holt, Rinehart & Winston. 1972.

12. Birdwhistell RL: Kinesics and Context. Essays on BodyMotion Communication. Philadelphia. University ofPennsylvania Press. 1970.

13. Argyle M: Bodily Communication. 2nd ed. London. Methuen.1988.

14. Argyle M: Social Interaction. London. Methuen. 1969.

15. Mehrabian A, Ksionzky S: Some Determinants of SocialInteraction. Sociometry 1972; 35(4):588-609.

16. Rosenfeld HM: The Experimental Analysis of InterpersonalInfluence Processes. J Commun 1972; 22:424-442.

17. Argyle M, Dean J: Eye Contact, Distance and Affiliation.Sociometry 1965; 28(3):289-304.

18. Hall ET: The Hidden Dimension. Garden City, NY.Doubleday. 1966.

19. Kasl, SV, Mahl, GF: The Relationship of Disturbances andHesitations in Spontaneous Speech to Anxiety. J Pers SocPsychol 1965; 1:425-433.

20. Wiemann JM, Knapp ML: Turn-taking in Conversations. JCommun 1975; 25(2):75-92.

21. Wiener M, Mehrabian A: Language Within Language. NewYork. Appleton-Century-Croft. 1968.

22. Van den Stock J, Ruthger R, De Gelder B: Body ExpressionsInfluence Recognition of Emotions in the Face and Voice.Emotion 2007; 7(3):487-494.

23. Hannah A, Millichamp, CJ, Ayers KMS: A CommunicationSkills Course for Undergraduate Dental Students. Jl DentEduc 2004; 68(9):970-977.

24. Kulich KR, Beggren U, Hallberg LR: Model of the Dentist-Patient Consultation in a Clinic Specializing in the Treatmentof Dental Phobic Patients: a Qualitative Study. Acta OdontolScand 2000; 58:63-71.

25. Brattstrom V, Ingelsson M, Aberg E: Treatment Cooperationin Orthodontic Patients. Br J Orthod 1991; 18:37-42.

26. Van der Molen HT, Klaver AA, Duyx MP: Effectiveness of aCommunication Skills Training Programme for theManagement of Dental Anxiety. Br Dent J 2004; 196(2):101-107.

27. Yoshida T, Milgrom P, Coldwell S: How do U.S. andCanadian Dental Schools Teach InterpersonalCommunication Skills? J Dent Educ 2002; 66(11):1281-1288.

28. Huntington B, Kuhn N: Communication Gaffes: A RootCause of Malpractice Claims. BUMC Proceedings 2003;16:157-161.

29. Mellor AC, Milgrom P: Dentists’ Attitudes towardsFrustrating Patients’ Visits: Relationship to Satisfaction andMalpractice Complaints. J Public Health Dent 1996; 56:6-11.

30. Young GJ, Meterko M, Desai KR: Patient Satisfaction withHospital Care: Effects of Demographic and InstitutionalCharacteristics. Med Care 2000; 38(3):325-334.

31. Wagner J, Arteaga S, D’Ambrosio J, et al: A Patient-Instructor Program to Promote Dental Students’Communication Skills with Diverse Patients. J Dent Educ2007; 71(12):1554-1560.

32. Wiemann JM: Explication and Test of a Model ofCommunication Competence. Hum Commun Res 1977;3(3):195-213.

33. Berko RM, Wolvin AD, Wolvin DR: Communicating: A Socialand Career Focus. 3rd ed. Boston. Houghton Mifflin. 1985.

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EI™A°ø°HH Û¯¤ÛË ·Ó¿ÌÂÛ· ÛÙÔ ÁÈ·ÙÚfi Î·È ÙÔÓ ·ÛıÂÓ‹ Â›Ó·È ÍÂ-¯ˆÚÈÛÙ‹ Î·È ‰È·ÊÔÚÂÙÈÎ‹ ·fi fiÏÂ˜ ÙÈ˜ ¿ÏÏÂ˜ ÎÔÈÓˆÓÈÎ¤˜Û¯¤ÛÂÈ˜. TÔ ÂÓ‰È·Ê¤ÚÔÓ ÁÈ’ ·˘Ù‹Ó Â›Ó·È ÙfiÛÔ ·ÏÈfi fiÛÔÎ·È Ë ¿ÛÎËÛË ÙË˜ È·ÙÚÈÎ‹˜. AÓ·ÊÔÚ¤˜ ÛÙËÓ ËıÈÎ‹ ‰È¿-ÛÙ·ÛË ÙË˜ Û¯¤ÛË˜ ÁÈ·ÙÚÔ‡-·ÛıÂÓ‹ ˘¿Ú¯Ô˘Ó ‹‰Ë ÛÙÔÓ

ÎÒ‰ÈÎ· ÙÔ˘ X·ÌÔ˘Ú·Ì› (1700 .X.). ™ÙËÓ ·Ú¯·›· EÏÏ¿-‰· Ô IÔÎÚ¿ÙË˜, ÌÂ ÙÔÓ ŸÚÎÔ, Ù· ÎÂ›ÌÂÓ· Î·È ÙËÓ ·-Ú¿‰ÔÛË Ô˘ ‰ËÌÈÔ‡ÚÁËÛÂ, ¤ıÂÛÂ ÙÔ ËıÈÎfi Ï·›ÛÈÔ ÙË˜Û¯¤ÛË˜ ÁÈ·ÙÚÔ‡-·ÛıÂÓ‹ Î·È Î·Ù¤‰ÂÈÍÂ ÙË ÛËÌ·Û›· Î·ÈÙËÓ ·Í›· ÙË˜ ˆ˜ ıÂÚ·Â˘ÙÈÎfi ÂÚÁ·ÏÂ›Ô1,2. TÈ˜ ÙÂÏÂ˘Ù·›Â˜‰ÂÎ·ÂÙ›Â˜ ¤¯ÂÈ ·˘ÍËıÂ› ÙÔ ·Î·‰ËÌ·˚Îfi ÂÓ‰È·Ê¤ÚÔÓ ÁÈ·ÙË Û¯¤ÛË ÁÈ·ÙÚÔ‡-·ÛıÂÓ‹, Î·ıÒ˜ ¤ÁÈÓÂ ·ÓÙÈÏËÙfi ˆ˜Ë ıÂÚ·Â˘ÙÈÎ‹ Û¯¤ÛË Â›Ó·È ·Ó·fiÛ·ÛÙÔ ÎÔÌÌ¿ÙÈ ÙË˜ıÂÚ·Â›·˜. ™Ùfi¯Ô˜ Â›Ó·È Ë Â›ÙÂ˘ÍË Î·Ï‡ÙÂÚÔ˘ ıÂÚ·-Â˘ÙÈÎÔ‡ ·ÔÙÂÏ¤ÛÌ·ÙÔ˜ Î·È Ë ÌÂÁ·Ï‡ÙÂÚË ÈÎ·ÓÔÔ›Ë-ÛË ÁÈ·ÙÚÔ‡ Î·È ·ÛıÂÓ‹. H Û¯¤ÛË Ô‰ÔÓÙÈ¿ÙÚÔ˘-·ÛıÂÓ‹·ÔÙÂÏÂ› Ì¤ÚÔ˜ ÙË˜ Â˘Ú‡ÙÂÚË˜ Û¯¤ÛË˜ ÁÈ·ÙÚÔ‡-·ÛıÂ-Ó‹. H ¿ÛÎËÛË ÛÙÔ ÓÔÛÔÎÔÌÂ›Ô ÙË˜ O‰ÔÓÙÈ·ÙÚÈÎ‹˜ EÈ‰È-Î‹˜ ºÚÔÓÙ›‰·˜ (Special Care Dentistry) Î·È Ë ·ÓÙÈÌÂÙÒ-ÈÛË ÂÈ‰ÈÎÒÓ Î·ÙËÁÔÚÈÒÓ ·ÛıÂÓÒÓ ‰›ÓÔ˘Ó È‰È·›ÙÂÚË ‰È¿-ÛÙ·ÛË ÛÙË Û¯¤ÛË Ô‰ÔÓÙÈ¿ÙÚÔ˘-·ÛıÂÓ‹. ™ÎÔfi˜ ÙË˜ ÂÚ-


BÂÏÙÈÒÓÔÓÙ·˜ ÙË ™¯¤ÛË O‰ÔÓÙÈ¿ÙÚÔ˘-AÛıÂÓ‹. MÂ ¤ÌÊ·ÛË ÛÙÔÓ EÈ‰ÈÎfi AÛıÂÓ‹

MÔÁÔÛÈ¿Ó E˘·ÁÁÂÏ›·*

TÈ˜ ÙÂÏÂ˘Ù·›Â˜ ‰ÂÎ·ÂÙ›Â˜ Ë ‚ÂÏÙ›ˆÛË ÙË˜ Û¯¤ÛË˜ ÁÈ·ÙÚÔ‡-·ÛıÂÓ‹ ¤¯ÂÈ Á›ÓÂÈ ·ÓÙÈÎÂ›ÌÂÓÔ ÌÂ-ÏÂÙÒÓ Ô˘ ·ÔÛÎÔÔ‡Ó ÛÙËÓ Â›ÙÂ˘ÍË Î·Ï‡ÙÂÚÔ˘ ıÂÚ·Â˘ÙÈÎÔ‡ ·ÔÙÂÏ¤ÛÌ·ÙÔ˜ Î·È ÌÂÁ·-Ï‡ÙÂÚË˜ ÈÎ·ÓÔÔ›ËÛË˜ ÁÈ·ÙÚÔ‡ Î·È ·ÛıÂÓ‹. ™ÎÔfi˜ ÙË˜ ÂÚÁ·Û›·˜ ·˘Ù‹˜ Â›Ó·È Ó· ·ÚÔ˘ÛÈ¿-ÛÂÈ ¤Ó· Ï·›ÛÈÔ ·ÓÙÈÏ‹„ÂˆÓ ÁÈ· ÙË Û¯¤ÛË Ô‰ÔÓÙÈ¿ÙÚÔ˘-·ÛıÂÓ‹, Ô˘ ı· Û˘Ì‚¿ÏÏÂÈ ÛÙË ‚ÂÏ-Ù›ˆÛË ÙË˜, ÌÂ ¤ÌÊ·ÛË ÛÙÔÓ Ô‰ÔÓÙÈ·ÙÚÈÎfi ·ÛıÂÓ‹ Ô˘ ¿Û¯ÂÈ ·fi Û˘ÛÙËÌ·ÙÈÎ¿ ÓÔÛ‹Ì·Ù·. H Û˘Ó·ÈÛıËÌ·ÙÈÎ‹ Î·Ù·ÓfiËÛË-ÂÓÛ˘Ó·›ÛıËÛË Â›Ó·È ÙÔ Û˘Ó·›ÛıËÌ· Ô˘ Ú¤ÂÈ Ó· ·Ó·Ù‡Û-ÛÂÙ·È ÚÔ˜ ÙÔÓ ·ÛıÂÓ‹. H ıÂÚ·Â˘ÙÈÎ‹ Û¯¤ÛË Ú¤ÂÈ Ó· ‚·Û›˙ÂÙ·È ÛÙËÓ ·Ú¯‹ ÙÔ˘ ÛÂ‚·-ÛÌÔ‡ ÙË˜ ·˘ÙÔÓÔÌ›·˜ ÙÔ˘. H Ï‹„Ë Û˘ÁÎ·Ù¿ıÂÛË˜ ÌÂÙ¿ ·fi ÂÓËÌ¤ÚˆÛË, ÁÈ· Ô‰ÔÓÙÈ·ÙÚÈÎ¤˜ıÂÚ·Â›Â˜ Î·È ÂÂÌ‚¿ÛÂÈ˜, Â›Ó·È ··Ú·›ÙËÙË Î·È ˘ÔÛÙËÚ›˙ÂÈ ÙËÓ ·Ú¯‹ ÙË˜ ·˘ÙÔÓÔÌ›·˜ ÙÔ˘·ÛıÂÓ‹. H Î·Ï‹ ÂÈÎÔÈÓˆÓ›· Ì·˙› ÙÔ˘ Â›Ó·È ÚÔ¸fiıÂÛË ÁÈ· ÙË ‰ËÌÈÔ˘ÚÁ›· ıÂÚ·Â˘ÙÈÎ‹˜Û¯¤ÛË˜ Î·È ÙËÓ Ô˘ÛÈ·ÛÙÈÎ‹ ÂÓËÌ¤ÚˆÛË ÙÔ˘. ™˘ÛÙ·ÙÈÎfi ÎÔÌÌ¿ÙÈ ÙË˜ ÂÈÎÔÈÓˆÓ›·˜ Â›Ó·È Ë ÌËÏÂÎÙÈÎ‹ ÂÈÎÔÈÓˆÓ›· T· ÌËÓ‡Ì·Ù· ÙË˜ ÌË ÏÂÎÙÈÎ‹˜ ÂÈÎÔÈÓˆÓ›·˜ Ú¤ÂÈ Ó· Û˘Ì‚·‰›˙Ô˘Ó ÌÂÙ· ÏÂÎÙÈÎ¿ ÌËÓ‡Ì·Ù· ÚÔ˜ ÙÔÓ ·ÛıÂÓ‹. ™ÙË ‰È¿ÚÎÂÈ· ÙË˜ ıÂÚ·Â˘ÙÈÎ‹˜ Û¯¤ÛË˜ Î·È ÌÂÙ¿ ·-fi ·˘Ù‹Ó Ë ÚÔÛÙ·Û›· ÙÔ˘ È·ÙÚÈÎÔ‡ ·ÔÚÚ‹ÙÔ˘ ·ÔÙÂÏÂ› ¿ÁÈ· ˘Ô¯Ú¤ˆÛË ÙÔ˘ Ô‰ÔÓÙÈ¿-ÙÚÔ˘ ÚÔ˜ ÙÔÓ ·ÛıÂÓ‹. ¶·ÚfiÏÔ Ô˘ ÔÈ ·Ú·¿Óˆ ·Ú¯¤˜ ÈÛ¯‡Ô˘Ó ÁÈ· Î¿ıÂ Ô‰ÔÓÙÈ·ÙÚÈÎfi ·ÛıÂÓ‹, Ë ÂÊ·ÚÌÔÁ‹ÙÔ˘˜ ¤¯ÂÈ È‰È·›ÙÂÚË ÛËÌ·Û›· fiÙ·Ó ·ÓÙÈÌÂÙˆ›˙ÂÙ·È ·ÛıÂÓ‹˜ ÌÂ Û˘ÛÙËÌ·ÙÈÎ¿ ÓÔÛ‹Ì·Ù·, ·-Ó·ËÚ›·, ÓÔËÙÈÎ‹ ˘ÛÙ¤ÚËÛË, Î·Ù¿ ÙËÓ ¿ÛÎËÛË O‰ÔÓÙÈ·ÙÚÈÎ‹˜ EÈ‰ÈÎ‹˜ ºÚÔÓÙ›‰·˜ ÛÙÔ NÔ-ÛÔÎÔÌÂ›Ô.


§¤ÍÂÈ˜ ÎÏÂÈ‰È¿: ™¯¤ÛË Ô‰ÔÓÙÈ¿ÙÚÔ˘-·ÛıÂÓ‹, ÂÓÛ˘Ó·›ÛıËÛË, ·˘ÙÔÓÔÌ›·, ÂÈÎÔÈÓˆÓ›·, È·ÙÚÈÎfi ·fiÚÚËÙÔ

*EÈÌÂÏ‹ÙÚÈ· A’ O‰ÔÓÙÈ·ÙÚÈÎ‹˜ KÏÈÓÈÎ‹˜ ¶·ÓÂÈÛÙËÌÈ·ÎÔ‡ °ÂÓÈÎÔ‡ NÔÛÔÎÔÌÂ›Ô˘ HÚ·ÎÏÂ›Ô˘

H ÂÚÁ·Û›· ·˘Ù‹ ¤¯ÂÈ ·ÚÔ˘ÛÈ·ÛıÂ› ÛÙÔ 4Ô ¶·ÓÂÏÏ‹ÓÈÔ ™˘Ó¤‰ÚÈÔNÔÛÔÎÔÌÂÈ·Î‹˜ O‰ÔÓÙÈ·ÙÚÈÎ‹˜, 30/9 -2/10/2011, Aı‹Ó·

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Á·Û›·˜ ·˘Ù‹˜ Â›Ó·È Ó· ·ÚÔ˘ÛÈ¿ÛÂÈ ¤Ó· Ï·›ÛÈÔ ·ÓÙÈÏ‹-„ÂˆÓ ÁÈ· ÙË Û¯¤ÛË Ô‰ÔÓÙÈ¿ÙÚÔ˘-·ÛıÂÓ‹, Ô˘ ı· Û˘Ì-‚¿ÏÏÂÈ ÛÙË ‚ÂÏÙ›ˆÛË ÙË˜, ÌÂ ¤ÌÊ·ÛË ÛÙÔÓ Ô‰ÔÓÙÈ·ÙÚÈÎfi·ÛıÂÓ‹ Ô˘ ¿Û¯ÂÈ ·fi Û˘ÛÙËÌ·ÙÈÎ¿ ÓÔÛ‹Ì·Ù·.

H ¢HMIOYP°IA TH™ ™XE™H™ O¢ONTIATPOY-A™£ENHH Û¯¤ÛË Ô‰ÔÓÙÈ¿ÙÚÔ˘-·ÛıÂÓ‹ ÍÂÎÈÓ¿ ÌÂ ÙËÓ ÚÒÙË ÌÂ-Ù·Í‡ ÙÔ˘˜ Û˘Ó¿ÓÙËÛË, ¯Ù›˙ÂÙ·È ÛÙ·‰È·Î¿ Î·È Â‰Ú·ÈÒÓÂ-Ù·È ÌÂ ÙÔ ̄ ÚfiÓÔ. K·Ïfi Â›Ó·È Ó· ÚÔÛÂ¯ıÂ› ÒÛÙÂ Ô ̄ ÚfiÓÔ˜·Ó·ÌÔÓ‹˜ ÁÈ· ÙÔÓ ·ÛıÂÓ‹, È‰È·›ÙÂÚ· ÛÙËÓ ÚÒÙË Û˘Ó¿-ÓÙËÛË, Ó· ÌËÓ Â›Ó·È ÌÂÁ¿ÏÔ˜. O ¯ÒÚÔ˜ ˘Ô‰Ô¯‹˜ ÙÔ˘·ÛıÂÓ‹ Ú¤ÂÈ Ó· Â›Ó·È Î·Ù¿ÏÏËÏÔ˜ ÛÂ Ì¤ÁÂıÔ˜, Î·ı·-Úfi˜ Î·È Ù·ÎÙÔÔÈËÌ¤ÓÔ˜. N· ¤¯ÂÈ Â·ÚÎ‹ Î·È Î·Ù¿ ÚÔ-Ù›ÌËÛË Ê˘ÛÈÎfi ÊˆÙÈÛÌfi. N· ¤¯ÂÈ ÏÈÙ‹ Î·È ÏÂÈÙÔ˘ÚÁÈÎ‹ Â›-ÏˆÛË Î·È ‰È·ÎfiÛÌËÛË. ¢ÂÓ Ú¤ÂÈ Ó· ¤¯ÂÈ ÂÈÎfiÓÂ˜ Î·ÈÊˆÙÔÁÚ·Ê›Â˜ ÌÂ ÂÚÈÂ¯fiÌÂÓÔ Ô˘ ÌÔÚÂ› ÛÂ Î¿ÔÈÔ Ó·ÚÔÎ·ÏÂ› Êfi‚Ô1,3. H ˘Ô‰Ô¯‹ ÙÔ˘ ·ÛıÂÓ‹ ÌÂ ¯ÂÈÚ·„›·Û˘Ì‚¿ÏÏÂÈ ÛÙË ‰ËÌÈÔ˘ÚÁ›· ÈÔ ˙ÂÛÙ‹˜ ·ÙÌfiÛÊ·ÈÚ·˜ Î·È‰›‰ÂÈ ÏËÚÔÊÔÚ›Â˜ ÁÈ· ·˘ÙfiÓ. °È· ·Ú¿‰ÂÈÁÌ·, Ô ·ÛıÂ-Ó‹˜ ÌÂ „˘¯Ú¿ Î·È ˘ÁÚ¿ ¯¤ÚÈ· Â›Ó·È ·Á¯ˆÌ¤ÓÔ˜ ·ÛıÂÓ‹˜Î·È ¯ÚÂÈ¿˙ÂÙ·È ÂÈ‰ÈÎ‹ ·ÓÙÈÌÂÙÒÈÛË4. H Ï‹„Ë ÙÔ˘ È·ÙÚÈÎÔ‡ Î·È Ô‰ÔÓÙÈ·ÙÚÈÎÔ‡ ÈÛÙÔÚÈÎÔ‡ ·Ô-ÙÂÏÂ› ÙËÓ ÚÒÙË Â·Ê‹ ÌÂ ÙÔÓ ·ÛıÂÓ‹. H ‰È·‰ÈÎ·Û›· ·˘-Ù‹ Ú¤ÂÈ Ó· Â›Ó·È Ì›· ˙ÂÛÙ‹, ·ÓıÚÒÈÓË Û¯¤ÛË. O ¯Ò-ÚÔ˜ ÂÍ¤Ù·ÛË˜ Ú¤ÂÈ Ó· ¤¯ÂÈ ÙÔÓ ··Ú·›ÙËÙÔ ÂÍÔÏÈÛÌfiÎ·È Ó· ÂÍ·ÛÊ·Ï›˙ÂÈ ÙËÓ È‰ÈˆÙÈÎfiÙËÙ· Î·È ÙÔ ÛÂ‚·ÛÌfi ÙË˜ÚÔÛˆÈÎfiÙËÙ·˜ ÙÔ˘. N· ¤¯ÂÈ Î·Ù¿ÏÏËÏË ıÂÚÌÔÎÚ·Û›·¶Ú¤ÂÈ Ó· Â›Ó·È ¯ÒÚÔ˜ ··ÏÏ·ÁÌ¤ÓÔ˜ ·fi ıÔÚ‡‚Ô˘˜(ÊˆÓ¤˜, Á¤ÏÈ·, ÌÔ˘ÛÈÎ‹, ÎÈÓËÙ¿ ÙËÏ¤ÊˆÓ·). ™ÙË ‰È¿ÚÎÂÈ·ÙË˜ Ï‹„Ë˜ ÙÔ˘ ÈÛÙÔÚÈÎÔ‡ Î·È ÙË˜ ÎÏÈÓÈÎ‹˜ ÂÍ¤Ù·ÛË˜ ÙÔ˘·ÛıÂÓ‹ ÙÔ ÂÓ‰È·Ê¤ÚÔÓ ÙÔ˘ Ô‰ÔÓÙÈ¿ÙÚÔ˘ Â›Ó·È ·ÔÎÏÂÈ-ÛÙÈÎ¿ ÂÛÙÈ·ÛÌ¤ÓÔ ÛÂ ·˘ÙfiÓ. O Ô‰ÔÓÙ›·ÙÚÔ˜ ‰ÂÓ ÙÚÒÂÈ,‰ÂÓ Ì·Û¿ÂÈ ÙÛ›¯Ï·, ‰ÂÓ Î·Ó›˙ÂÈ, ‰ÂÓ ÁÂÏ¿ÂÈ, ‰ÂÓ ·Û¯Ô-ÏÂ›Ù·È ÌÂ ÎÈÓËÙfi, ̆ ÔÏÔÁÈÛÙ‹ ‹ Î¿ÙÈ ¿ÏÏÔ. AÎfiÌ· ‰ÂÓ Û¯Ô-ÏÈ¿˙ÂÈ Î·È ‰ÂÓ ÚÔ‰›‰ÂÈ ÌÂ ÂÎÊÚ¿ÛÂÈ˜ Ù· Û˘Ó·ÈÛı‹Ì·Ù·ÙÔ˘. AÓ Ô ·ÛıÂÓ‹˜ Â›Ó·È ·Î¿ı·ÚÙÔ˜, ‰‡ÛÔÛÌÔ˜ ‹ ÊÔÚ¤-·˜ ÌÔÏ˘ÛÌ·ÙÈÎ‹˜ ÓfiÛÔ˘ ‰ÂÓ ÂÎ‰ËÏÒÓÂÈ ÙË ‰˘ÛÊÔÚ›· ÙÔ˘.AÔÊÂ‡ÁÂÈ ÙÔ ÂÈ‰ÂÈÎÙÈÎfi ÊfiÚÂÌ· ÙˆÓ Á·ÓÙÈÒÓ Î·È ÙÔ‚È·ÛÙÈÎfi Ï‡ÛÈÌÔ ÙˆÓ ¯ÂÚÈÒÓ Ô˘ ÌÔÚÂ› Ó· ÚÔÛ‚¿Ï-ÏÂÈ ÙÔÓ ·ÛıÂÓ‹. ŸÌˆ˜ ¤¯ÂÈ ÙÔ ‰ÈÎ·›ˆÌ· Ó· ÂÓËÌÂÚÒÛÂÈÙÔÓ ·ÛıÂÓ‹ ÁÈ· ÙËÓ ̆ Ô¯Ú¤ˆÛ‹ ÙÔ˘ Ó· ÚÔÛ¤Ú¯ÂÙ·È Î·-ı·Úfi˜ Î·È ÌÂ Î·ı·Ú¿ ÚÔ‡¯· ÁÈ· ÂÍ¤Ù·ÛË. E›Ó·È ÛÎfiÈÌÔË ÎÏÈÓÈÎ‹ ÂÍ¤Ù·ÛË ÙÔ˘ ·ÛıÂÓ‹ Ó· Ú·ÁÌ·ÙÔÔÈÂ›Ù·È ·-ÚÔ˘Û›· ÓÔÛËÏÂ˘ÙÈÎÔ‡ ÚÔÛˆÈÎÔ‡, ·ÏÏ¿ ¯ˆÚ›˜ ÙÚ›Ù·¿ÙÔÌ· ÛÙÔ È·ÙÚÂ›Ô. AÓ ÂÍÂÙ¿˙ÂÙ·È ÓÔÛËÏÂ˘fiÌÂÓÔ˜ ·ÛıÂ-Ó‹˜ Â› ÎÏ›ÓË˜, Ë ÂÍ¤Ù·ÛË Ú·ÁÌ·ÙÔÔÈÂ›Ù·È ÌÂÙ¿ ÙËÓ·Ô¯ÒÚËÛË fiÏˆÓ ÙˆÓ ·ÙfiÌˆÓ, ÏËÓ ÙˆÓ ÓÔÛËÏÂ˘ÔÌ¤-ÓˆÓ, ·fi ÙÔ ı¿Ï·ÌÔ1,3.

TA ™YNAI™£HMATA A¶ENANTI ™TON A™£ENH.EN™YNAI™£H™H ◊ ™YM¶ONIA;Ÿˆ˜ Â›Ó·È Ê˘ÛÈÎfi ÌÂÙ·Í‡ Ô‰ÔÓÙÈ¿ÙÚÔ˘ Î·È ·ÛıÂÓ‹ ‰Ë-ÌÈÔ˘ÚÁÔ‡ÓÙ·È ‰È¿ÊÔÚ· Û˘Ó·ÈÛı‹Ì·Ù·. E›Ó·È ÛËÌ·ÓÙÈÎfiÙ· Û˘Ó·ÈÛı‹Ì·Ù· ÙÔ˘ Ô‰ÔÓÙÈ¿ÙÚÔ˘ ÚÔ˜ ÙÔÓ ·ÛıÂÓ‹ Ó·Â›Ó·È Ù¤ÙÔÈ· Ô˘ Ó· ‰˘Ó·ÌÒÓÔ˘Ó ÙË ıÂÚ·Â˘ÙÈÎ‹ Û¯¤ÛË.EÓÛ˘Ó·›ÛıËÛË ‹ ™˘Ó·ÈÛıËÌ·ÙÈÎ‹ Î·Ù·ÓfiËÛË (Empathy)Â›Ó·È Ë ÈÎ·ÓfiÙËÙ· Î¿ÔÈÔ˘ Ó· ÌÔÈÚ·ÛÙÂ› Ù· ·ÈÛı‹Ì·Ù· Î¿-

ÔÈÔ˘ ¿ÏÏÔ˘. H Î·Ù·ÓfiËÛË, Ë Â›ÁÓˆÛË, Ë Â˘·ÈÛıËÛ›·,Ë ·ÓÙ›ÏË„Ë ÙˆÓ Û˘Ó·ÈÛıËÌ¿ÙˆÓ, ÙˆÓ ÛÎ¤„ÂˆÓ, ÙˆÓ ÂÌÂÈ-ÚÈÒÓ Î¿ÔÈÔ˘ ¿ÏÏÔ˘, ¯ˆÚ›˜ fiÌˆ˜ Ó· ‰ËÌÈÔ˘ÚÁÂ›Ù·È Ù·‡-ÙÈÛË ÌÂ Ù· ·ÈÛı‹Ì·Ù·, ÙÈ˜ ÛÎ¤„ÂÈ˜ Î·È ÙÈ˜ ÂÌÂÈÚ›Â˜ ÙÔ˘1,5.™˘ÌfiÓÈ· (Sympathy) Â›Ó·È Ô Ô›ÎÙÔ˜ Î·È Ë Ï‡Ë Î¿ÔÈÔ˘ÁÈ· ÙËÓ Î·ÎÔÙ˘¯›· Î¿ÔÈÔ˘ ¿ÏÏÔ˘. H Û˘ÌfiÓÈ· ‰ÂÓ Â›Ó·ÈÙÔ ÛˆÛÙfi Û˘Ó·›ÛıËÌ· ÚÔ˜ ÙÔÓ ·ÛıÂÓ‹. O Ô‰ÔÓÙ›·ÙÚÔ˜,fiˆ˜ Î·È Î¿ıÂ ÏÂÈÙÔ˘ÚÁfi˜ ˘ÁÂ›·˜, Ú¤ÂÈ Ó· ÂÎ·È‰Â‡-ÂÙ·È ÒÛÙÂ Ó· ·ÔÎÙ‹ÛÂÈ ÂÓÛ˘Ó·›ÛıËÛË ÚÔ˜ ÙÔÓ ·ÛıÂ-Ó‹, Ó· Î·Ù·ÓÔÂ› ÙË ı¤ÛË Î·È Ù· ÚÔ‚Ï‹Ì·Ù· ÙÔ˘, Ó· ÙÔ˘ÚÔÛÊ¤ÚÂÈ „˘¯ÈÎ‹ ÛÙ‹ÚÈÍË ÛÙÔ Ï·›ÛÈÔ ÌÈ·˜ Î·Ù¿ ÙÔ ‰˘-Ó·ÙfiÓ ÔÏÈÛÙÈÎ‹˜ ·ÓÙÈÌÂÙÒÈÛË˜1. H Â›‰ÂÈÍË ÂÓÛ˘Ó·›-ÛıËÛË˜ Â›Ó·È ıÂÌÂÏÈÒ‰Ë˜ ·Ú¯‹ ÛÙËÓ ÂÚ›ı·Ï„Ë, Û˘Ì-‚¿ÏÏÂÈ ÛÙË ÌÂ›ˆÛË Èı·ÓÔ‡ ı˘ÌÔ‡ Î·È ·ÔÁÔ‹ÙÂ˘ÛË˜ ÙÔ˘·ÛıÂÓ‹ Î·È ÛÙËÓ ·‡ÍËÛË ÙË˜ ıÂÚ·Â˘ÙÈÎ‹˜ ‰˘Ó·ÌÈÎ‹˜ÙË˜ Û¯¤ÛË˜. ¶ÚÔÛ‰›‰ÂÈ ÓfiËÌ· Î·È ÏÔ‡ÙÔ ÛÙËÓ ¿ÛÎËÛËÙË˜ È·ÙÚÈÎ‹˜ Î·È ÚÔÛÊ¤ÚÂÈ ÈÎ·ÓÔÔ›ËÛË ÛÙÔ ıÂÚ¿Ô-ÓÙ·6,7. AÔÎÙ¿ È‰È·›ÙÂÚË ‰È¿ÛÙ·ÛË ÛÙËÓ ¿ÛÎËÛË ÙË˜ Ô‰Ô-ÓÙÈ·ÙÚÈÎ‹˜ ÛÙÔ NÔÛÔÎÔÌÂ›Ô, ÂÍ·ÈÙ›·˜ ÙË˜ Ê‡ÛË˜ Î·È ÙˆÓÈ‰È·›ÙÂÚˆÓ ÚÔ‚ÏËÌ¿ÙˆÓ ÙˆÓ ·ÛıÂÓÒÓ Ô˘ ·ÓÙÈÌÂÙˆ›-˙ÔÓÙ·È. E›Ó·È ÛËÌ·ÓÙÈÎfi Ô ·ÛıÂÓ‹˜ ÌÂ ¯ÚfiÓÈ· ÓÔÛ‹Ì·Ù·,ÌÂ Ê˘ÛÈÎ‹ ‹ ÓÔËÙÈÎ‹ ·Ó·ËÚ›·, ÌÂ Î·ÚÎ›ÓÔ -ÂÓ‰Â¯ÔÌ¤Óˆ˜ÙÂÏÈÎÔ‡ ÛÙ·‰›Ô˘- Ó· ·ÓÙÈÌÂÙˆ›˙ÂÙ·È ÌÂ ÂÓÛ˘Ó·›ÛıËÛËÎ·È fi¯È Û˘ÌfiÓÈ· Î·È Ó· ÙÔ˘ ·Ú¤¯ÂÙ·È Ë Î·Ï‡ÙÂÚË ‰˘-Ó·Ù‹ ÁÈ· ÙËÓ ÂÚ›ÙˆÛË ÙÔ˘ ÂÚ›ı·Ï„Ë.

™EBA™MO™ TH™ AYTONOMIA™ TOY A™£ENHAfi ÙËÓ ÂÔ¯‹ ÙÔ˘ IÔÎÚ¿ÙË Ì¤¯ÚÈ ÂÚ›Ô˘ ÙÈ˜ ‰ÂÎ·Â-Ù›Â˜ ÙÔ˘ ’50 Î·È ÙÔ˘ ’60 ÂÈÎÚ·ÙÔ‡ÛÂ ÙÔ «·ÙÂÚÓ·ÏÈÛÙÈ-Îfi» ÚfiÙ˘Ô ÛÙË Û¯¤ÛË ÁÈ·ÙÚÔ‡-·ÛıÂÓ‹. ™‡ÌÊˆÓ· ÌÂ·˘Ùfi Ô ÁÈ·ÙÚfi˜ ·›ÚÓÂÈ ÙÈ˜ ·ÔÊ¿ÛÂÈ˜ ÁÈ· ÙÔÓ Î·ıÔÚÈ-ÛÌfi ÙË˜ ıÂÚ·Â›·˜, ÌÂ ÌÈÎÚ‹ ˆ˜ Î·ıfiÏÔ˘ Û˘ÌÌÂÙÔ¯‹ÙÔ˘ ÙÂÏÂ˘Ù·›Ô˘. H Â˘ı‡ÓË ÙÔ˘ ·ÛıÂÓ‹ ÂÚÈÔÚ›˙ÂÙ·È ÛÙËÓ˘Ô¯Ú¤ˆÛË Û˘ÌÌfiÚÊˆÛ‹˜ ÙÔ˘ ÌÂ ÙÈ˜ ÂÓÙÔÏ¤˜ ÙÔ˘ ÁÈ·-ÙÚÔ‡1,8. TÈ˜ ÙÂÏÂ˘Ù·›Â˜ ‰ÂÎ·ÂÙ›Â˜ ÚÔÎÚ›ÓÂÙ·È ¤Ó· Ó¤ÔÌÔÓÙ¤ÏÔ ÛÙÈ˜ Û¯¤ÛÂÈ˜ ÁÈ·ÙÚÔ‡-·ÛıÂÓ‹, Ô˘ ‰›ÓÂÈ ¤ÌÊ·-ÛË ÛÙËÓ ·˘ÙÔÓÔÌ›· ÙÔ˘ ·ÛıÂÓ‹. H ·Ú¯‹ ÙË˜ ·˘ÙÔÓÔÌ›·˜·Ó·Ê¤ÚÂÙ·È ÛÙÔ ‰ÈÎ·›ˆÌ· Î¿ıÂ ·ÓıÚÒÔ˘ Ó· Î¿ÓÂÈ ÙÈ˜‰ÈÎ¤˜ ÙÔ˘ ÂÈÏÔÁ¤˜, ÛÂ fi,ÙÈ ·ÊÔÚ¿ ÛÙËÓ ˘ÁÂ›· Î·È ÛÙËıÂÚ·Â›· ÙÔ˘, ÌÂ ‚¿ÛË ÙÈ˜ ‰ÈÎ¤˜ ÙÔ˘ ÚÔÛˆÈÎ¤˜ Â-ÔÈı‹ÛÂÈ˜ Î·È ·Í›Â˜1,2,8-13. ™‹ÌÂÚ· ıÂˆÚÂ›Ù·È fiÙÈ Ô ·ÛıÂÓ‹˜, ÂÊfiÛÔÓ ÙÔ ÂÈı˘ÌÂ›,Ú¤ÂÈ Ó· Â›Ó·È ÂÓ‹ÌÂÚÔ˜ ÁÈ· ÙËÓ Î·Ù¿ÛÙ·ÛË ÙË˜ ˘ÁÂ›·˜ÙÔ˘, ÙÈ˜ ÂÓ·ÏÏ·ÎÙÈÎ¤˜ ıÂÚ·Â˘ÙÈÎ¤˜ ÂÈÏÔÁ¤˜ Ô˘ ‰È·-ı¤ÙÂÈ, Ù· ÏÂÔÓÂÎÙ‹Ì·Ù· Î·È Ù· ÌÂÈÔÓÂÎÙ‹Ì·Ù· Î¿ıÂ ÂÈ-ÏÔÁ‹˜, ÙÈ˜ ÂÓ‰Â¯fiÌÂÓÂ˜ ·ÚÂÓ¤ÚÁÂÈÂ˜ ÙˆÓ ıÂÚ·ÂÈÒÓ.MÔÚÂ› Ó· Û˘Ó·ÈÓÂ› ‹ Ó· ·ÚÓÂ›Ù·È ÙËÓ ÚÔÙÂÈÓfiÌÂÓË ıÂ-Ú·Â›·8. ™Â Î·ÌÈ¿ ÂÚ›ÙˆÛË ‰ÂÓ Ú¤ÂÈ Ó· ÙÔ˘ ‰ËÌÈ-Ô˘ÚÁÂ›Ù·È Ë ·ÓÙ›ÏË„Ë fiÙÈ Â›Ó·È ·Ó‹ÌÔÚÔ˜ Î·È ¤¯ÂÈ ¯¿ÛÂÈÙÔÓ ¤ÏÂÁ¯Ô. ™Â fiÔÈ· Î·Ù¿ÛÙ·ÛË Î·È ·Ó ‚Ú›ÛÎÂÙ·È Ú¤-ÂÈ Ó· ˘¿Ú¯ÂÈ ÛÂ‚·ÛÌfi˜ ÛÙËÓ ·ÍÈÔÚ¤ÂÈ· Î·È ÙËÓ ·ÙÔ-ÌÈÎfiÙËÙ· ÙÔ˘ Î·È Ó· Î·Ù·‚¿ÏÏÂÙ·È ÚÔÛ¿ıÂÈ· ¿Ì‚Ï˘Ó-ÛË˜ Ù˘¯fiÓ ÂÓÔ¯ÈÎÒÓ ÙÔ˘ ÚÔ‚ÏËÌ¿ÙˆÓ14. XÚÂÈ¿˙ÂÙ·È Ó·Î·Ù·‚¿ÏÏÂÙ·È ÚÔÛ¿ıÂÈ· ÒÛÙÂ ·ÛıÂÓÂ›˜ ÌÂ ÛÔ‚·Ú¿ÚÔ‚Ï‹Ì·Ù· ˘ÁÂ›·˜ (Î·ÚÎÈÓÔ·ıÂ›˜ ÛÂ ÚÔ¯ˆÚËÌ¤Ó·ÛÙ¿‰È· ÙË˜ ÓfiÛÔ˘, ·ÛıÂÓÂ›˜ ÌÂ ÙÚ·¯ÂÈÔÛÙÔÌ›· ‹ ·ÁÁÂÈ·-Îfi ÂÁÎÂÊ·ÏÈÎfi ÂÂÈÛfi‰ÈÔ Î·È ‰˘ÛÎÔÏ›· ÛÙËÓ ÂÎÊÔÚ¿ ÙÔ˘ÏfiÁÔ˘, „˘¯È·ÙÚÈÎÔ› ÎÏ), Ó· ·ÓÙÈÌÂÙˆ›˙ÔÓÙ·È ÌÂ ÛÂ‚·-

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ÛÌfi, ¯ˆÚ›˜ Ó· ·Ú·Î¿ÌÙÔÓÙ·È Î·È Ó· ‰ËÌÈÔ˘ÚÁÂ›Ù·È ËÂÓÙ‡ˆÛË ˆ˜ ÂÚ›Ô˘ ıÂˆÚÔ‡ÓÙ·È ‹‰Ë ÓÂÎÚÔ›.

™Y°KATA£E™H TOY A™£ENH META A¶O ENHMEPø™HH Û˘ÁÎ·Ù¿ıÂÛË ÙÔ˘ ·ÛıÂÓ‹ ÁÈ· È·ÙÚÈÎ¤˜ ıÂÚ·Â›Â˜ Î·ÈÂÂÌ‚¿ÛÂÈ˜ ÌÂÙ¿ ·fi ÂÓËÌ¤ÚˆÛË, ˘ÔÛÙËÚ›˙ÂÈ ÙËÓ ·Ú-¯‹ ÙË˜ ·˘ÙÔÓÔÌ›·˜. H ‰È·‰ÈÎ·Û›· ÙË˜ Û˘ÁÎ·Ù¿ıÂÛË˜ ‰ÂÓÌÔÚÂ› Ó· ÓÔÂ›Ù·È ˆ˜ ÌÈ· ÁÚ·ÊÂÈÔÎÚ·ÙÈÎ‹ ˘fiıÂÛË. ¢ÂÓÁ›ÓÂÙ·È ÁÈ· Ó· ÚÔÛÙ·ÙÂ‡ÛÂÈ ÙÔÓ Ô‰ÔÓÙ›·ÙÚÔ, ÛÙÔÓ ÔÔ›ÔÚÔÛÊ¤ÚÂÈ Î¿ÔÈ· Î·ÙÔ¯‡ÚˆÛË, ·ÏÏ¿ Î˘Ú›ˆ˜ ·ÔÛÎÔ-Â› ÛÙÔ ÛÂ‚·ÛÌfi ÙË˜ ·˘ÙÔÓÔÌ›·˜ ÙÔ˘ ·ÛıÂÓ‹. H Û˘ÁÎ·-Ù¿ıÂÛË ÚÔ¸Ôı¤ÙÂÈ ÂÈÏÈÎÚÈÓ‹ Î·È ·ÎÚÈ‚‹ ÂÓËÌ¤ÚˆÛË ÙÔ˘·ÛıÂÓ‹. O Ô‰ÔÓÙ›·ÙÚÔ˜ Ú¤ÂÈ Ó· Ï·Ì‚¿ÓÂÈ Û˘ÁÎ·Ù¿ıÂ-ÛË ÁÈ· ÙÔ Û¯¤‰ÈÔ ıÂÚ·Â›·˜ Ô˘ ı· ·ÎÔÏÔ˘ı‹ÛÂÈ, ·ÊÔ‡ÚÔËÁÔ˘Ì¤Óˆ˜ ÚÔ‚Â› ÛÙËÓ ··Ú·›ÙËÙË ÂÓËÌ¤ÚˆÛË ÙÔ˘·ÛıÂÓ‹. °È· Ó· Â›Ó·È Ô˘ÛÈ·ÛÙÈÎ‹ Ë ÂÓËÌ¤ÚˆÛË Ú¤ÂÈ ÔfiÁÎÔ˜, ÙÔ Â›‰Ô˜ Î·È Ô ÙÚfiÔ˜ ·ÚÔ¯‹˜ ÙˆÓ ÏËÚÔÊÔÚÈÒÓÛÙÔÓ ·ÛıÂÓ‹ Ó· Â›Ó·È Ù¤ÙÔÈÔ˜, Ô˘ Ú·ÁÌ·ÙÈÎ¿ Ó· ÙÔ˘ ‰›-ÓÔ˘Ó ÙÔ ‰ÈÎ·›ˆÌ· Ó· ÂÈÏ¤ÍÂÈ. O Î·Ù·ÈÁÈÛÌfi˜ ÙÔ˘ ·ÛıÂ-Ó‹ ·fi Ï‹ıÔ˜ ÂÚ›ÏÔÎˆÓ ÏËÚÔÊÔÚÈÒÓ ·ÔÙÂÏÂ› ÁÈ’·˘ÙfiÓ ·Ï¿ ÌÈ· «ÙÚ·ÁÈÎ‹ ÂÏÂ˘ıÂÚ›·» Ô˘ ·Î˘ÚÒÓÂÈ ÙË‰È·‰ÈÎ·Û›· Û˘ÁÎ·Ù¿ıÂÛË˜ ÙÔ˘. H ÂÓËÌ¤ÚˆÛË ÙÔ˘ ·ÛıÂ-Ó‹ Ú¤ÂÈ Ó· Á›ÓÂÙ·È ÌÂ ÙÚfiÔ Î·Ù·ÓÔËÙfi, ¯ˆÚ›˜ ÙË ¯Ú‹-ÛË ÂÚ›ÏÔÎˆÓ ÂÈÛÙËÌÔÓÈÎÒÓ fiÚˆÓ, Ô˘ Û›ÁÔ˘Ú· ÙÔÓ‰˘ÛÎÔÏÂ‡Ô˘Ó. H ¯Ú‹ÛË ÂÈÎfiÓˆÓ, ÁÚ·ÊËÌ¿ÙˆÓ ‹ ¿ÏÏˆÓÔÙÈÎÒÓ ‚ÔËıËÌ¿ÙˆÓ ‹ ÂÈ‰Â›ÍÂˆÓ ‚ÔËı¿ ÛÙËÓ Î·Ï‡ÙÂ-ÚË Î·Ù·ÓfiËÛË ÙˆÓ ıÂÌ¿ÙˆÓ Ô˘ ·ÚÔ˘ÛÈ¿˙ÔÓÙ·È. ¶Ú¤-ÂÈ Ó· ÂÎÙÈÌ¿Ù·È Ë ÚÔÛÔ¯‹ Î·È Ë ‰˘Ó·ÙfiÙËÙ· Î·Ù·ÓfiË-ÛË˜ ÙÔ˘. E¿Ó Â›Ó·È ˘ÂÚ‚ÔÏÈÎ¿ ·Á¯Ò‰Ë˜, ›Ûˆ˜ ‰ÂÓ ÌÔ-ÚÂ› Ó· ·ÊÔÌÔÈÒÛÂÈ ÙÈ˜ ÏËÚÔÊÔÚ›Â˜ Ô˘ ·Ú¤¯ÔÓÙ·È. K·-Ù¿ ÙË Û˘˙‹ÙËÛË Ú¤ÂÈ Ó· ÙÔ˘ ‰›ÓÂÙ·È Ë ‰˘Ó·ÙfiÙËÙ· Ó·ÂÎÊÚ¿ÛÂÈ ÙÈ˜ ·Í›Â˜ Î·È ÙÈ˜ ÚÔÙÂÚ·ÈfiÙËÙÂ˜ ÙÔ˘. H Ô˘-ÛÈ·ÛÙÈÎ‹ ‰È·‰ÈÎ·Û›· Û˘ÁÎ·Ù¿ıÂÛË˜ ÚÔ¸Ôı¤ÙÂÈ Û¯¤ÛËÎ·È ÂÈÎÔÈÓˆÓ›· Ô‰ÔÓÙÈ¿ÙÚÔ˘-·ÛıÂÓ‹ Î·È ‡·ÚÍË ‰ÂÛÌÒÓÂÌÈÛÙÔÛ‡ÓË˜ ÌÂÙ·Í‡ ÙÔ˘˜2,9,11,13-16.

H E¶IKOINøNIA ME TON A™£ENH TÈ˜ ÙÂÏÂ˘Ù·›Â˜ ‰ÂÎ·ÂÙ›Â˜ Ë ÂÈÎÔÈÓˆÓ›· ıÂˆÚÂ›Ù·È ‚·ÛÈ-Îfi Û˘ÛÙ·ÙÈÎfi ÙË˜ È·ÙÚÈÎ‹˜ ÊÚÔÓÙ›‰·˜. H Î·Ï‹ ÂÈÎÔÈÓˆ-Ó›· ıÂˆÚÂ›Ù·È ÛËÌ·ÓÙÈÎ‹ ÁÈ· ÙËÓ Â‰Ú·›ˆÛË ÏÂÈÙÔ˘ÚÁÈÎ‹˜Î·È ·ÔÙÂÏÂÛÌ·ÙÈÎ‹˜ Û¯¤ÛË˜ ÌÂ ÙÔÓ ·ÛıÂÓ‹. H ÂÈÎÔÈ-ÓˆÓÈ·Î‹ ÈÎ·ÓfiÙËÙ· ıÂˆÚÂ›Ù·È ‚·ÛÈÎ‹ ÎÏÈÓÈÎ‹ ‰ÂÍÈfiÙËÙ·Î·È Ë ‚ÂÏÙ›ˆÛË ÙË˜ ·ÔÏ‡Ùˆ˜ ··Ú·›ÙËÙË ÛÂ Î¿ıÂ Â›-Â‰Ô ·ÚÔ¯‹˜ ÊÚÔÓÙ›‰·˜ ˘ÁÂ›·˜1,17. OÈ ÛÎÔÔ› ÙË˜ ÂÈ-ÎÔÈÓˆÓ›·˜ ÁÈ·ÙÚÔ‡ ·ÛıÂÓ‹ Â›Ó·È: ñ H ‰ËÌÈÔ˘ÚÁ›· Î·Ï‹˜ ‰È·ÚÔÛˆÈÎ‹˜ Û¯¤ÛË˜ ñ H ·ÓÙ·ÏÏ·Á‹ ¯Ú‹ÛÈÌˆÓ ÏËÚÔÊÔÚÈÒÓ Î·È ñ H Ï‹„Ë ·ÔÊ¿ÛÂˆÓ Ô˘ Û¯ÂÙ›˙ÔÓÙ·È ÌÂ ÙË ıÂÚ·Â›·ÙÔ˘ ·ÛıÂÓ‹1.™ËÌ·ÓÙÈÎ‹ ·Ú¿ÌÂÙÚÔ˜ ÙË˜ ÂÈÎÔÈÓˆÓ›·˜ Â›Ó·È Ô ¯ÚfiÓÔ˜Ô˘ ·ÊÈÂÚÒÓÂÙ·È ÛÙÔÓ ·ÛıÂÓ‹ Î·È Ô ¯ÚfiÓÔ˜ Ô˘ ÙÔ˘ ‰›-ÓÂÙ·È ÁÈ· Ó· ÂÎı¤ÛÂÈ ÙÔ Úfi‚ÏËÌ· ÙÔ˘. K·ıÒ˜ ‰ÂÓ ̆ ¿Ú-¯Ô˘Ó ÛÙÔÈ¯Â›· ÁÈ· ÙËÓ ÂÈÎÔÈÓˆÓ›· Ô‰ÔÓÙÈ¿ÙÚÔ˘-·ÛıÂÓ‹,ÎÚ›ÓÂÙ·È ÛÎfiÈÌÔ Ó· ·Ú·ÙÂıÔ‡Ó ÛÙÔÈ¯Â›· ÌÂÏÂÙÒÓ ÁÈ·ÙËÓ ÂÈÎÔÈÓˆÓ›· ÁÈ·ÙÚÔ‡-·ÛıÂÓ‹, Ô˘ ÊˆÙ›˙Ô˘Ó ÛËÌ·-ÓÙÈÎ¤˜ ÏÂ˘Ú¤˜ ÙÔ˘ ˙ËÙ‹Ì·ÙÔ˜. MÂÏ¤ÙË ÁÈ· ÙËÓ ÎÂÊ·-Ï·ÏÁ›· ¤‰ÂÈÍÂ fiÙÈ Ë ÚfiÁÓˆÛË ÁÈ· ÙËÓ ıÂÚ·Â›· ÚÔ-

‚ÏËÌ¿ÙˆÓ ÎÂÊ·Ï·ÏÁ›·˜ ‰ÂÓ ÂÍ·ÚÙÈfiÙ·Ó Î˘Ú›ˆ˜ ·fi ÙË‰È¿ÁÓˆÛË, ÙÈ˜ ·ÚÂÌ‚¿ÛÂÈ˜, ÙÈ˜ ÁÓˆÌÔ‰ÔÙ‹ÛÂÈ˜ ‹ ÙÈ˜ Û˘-ÓÙ·Á¤˜. H Î·Ï‡ÙÂÚË ÚfiÁÓˆÛË ‹Ù·Ó Ë ·›ÛıËÛË ÙÔ˘ ·ÛıÂ-Ó‹ ˆ˜ Â›¯Â ÙËÓ Â˘Î·ÈÚ›· Ó· ÂÈ ÙËÓ ÈÛÙÔÚ›· ÙÔ˘ Î·È Ó·Û˘˙ËÙ‹ÛÂÈ ÙÔ Úfi‚ÏËÌ· ÙÔ˘ ÔÏÔÎÏËÚˆÌ¤Ó· ÌÂ ÙÔ ÁÈ·ÙÚfiÛÙËÓ ÚÒÙË ÙÔ˘ Â›ÛÎÂ„Ë18. H ÏËÚÔÊÔÚ›· ·˘Ù‹ ·Í›˙ÂÈÓ· Û˘Ó‰˘·ÛÙÂ› ÌÂ Ù· Â˘Ú‹Ì·Ù· ¿ÏÏË˜ ÌÂÏ¤ÙË˜, Ô˘ ¤‰ÂÈ-ÍÂ fiÙÈ ÔÈ ÁÈ·ÙÚÔ› Î·Ù¿ Ì¤ÛÔ fiÚÔ ‰È·ÎfiÙÔ˘Ó ÙÔ˘˜ ·ÛıÂ-ÓÂ›˜ ÙÔ˘˜ ÛÙ· 18 ‰Â˘ÙÂÚfiÏÂÙ· ÛÙË ‰È¿ÚÎÂÈ· ÌÈ·˜ Û˘Ó¤-ÓÙÂ˘ÍË˜19. H Â·Ó¿ÏË„Ë ÙË˜ ÌÂÏ¤ÙË˜ ·ÚÁfiÙÂÚ· ¤‰ÂÈÍÂ«‚ÂÏÙ›ˆÛË» Î·È ‰È·ÎÔ‹ ÙÔ˘ ·ÛıÂÓ‹ ÛÙ· 23 ‰Â˘ÙÂÚfiÏÂ-Ù·20. ™ÙËÓ ›‰È· ÌÂÏ¤ÙË ‚Ú¤ıËÎÂ fiÙÈ ÌfiÓÔ 8% ÙˆÓ ·ÛıÂ-ÓÒÓ Î·Ù¿ÊÂÚÓ·Ó Ó· Ô˘Ó ÙËÓ ÈÛÙÔÚ›· ÙÔ˘˜ ÔÏÔÎÏËÚˆ-Ì¤Ó· ÛÙÔ ÁÈ·ÙÚfi. T· Â˘Ú‹Ì·Ù· ÙˆÓ ·Ú·¿Óˆ ÌÂÏÂÙÒÓ‰Â›¯ÓÔ˘Ó ·ÊÂÓfi˜ ÌÂÓ ÙË ÛËÌ·Û›· ÙË˜ ÂÈÎÔÈÓˆÓ›·˜ ÁÈ·ÙÔÓ ·ÛıÂÓ‹ Î·È ·ÊÂÙ¤ÚÔ˘ ÌÈ· Ú·ÁÌ·ÙÈÎfiÙËÙ· ÁÈ· ÙË‰È¿ÚÎÂÈ· Î·È ÙËÓ ÔÈfiÙËÙ· ÙË˜ ÂÈÎÔÈÓˆÓ›·˜, Ô˘ Èı·-ÓfiÙ·Ù· ÔÈ ÁÈ·ÙÚÔ› ‰ÂÓ ¤¯Ô˘Ó Û˘ÓÂÈ‰ËÙÔÔÈ‹ÛÂÈ. °È·ÙÚÔ›Ô˘ ÚˆÙ‹ıËÎ·Ó Û¯ÂÙÈÎ¿ ıÂˆÚÔ‡Û·Ó ˆ˜ ·ÊÈ¤ÚˆÓ·Ó Â-ÚÈÛÛfiÙÂÚÔ ¯ÚfiÓÔ ÛÙÔ˘˜ ·ÛıÂÓÂ›˜ ÙÔ˘˜.H ÈÎ·ÓfiÙËÙ· ÂÈÎÔÈÓˆÓ›·˜ ‰ÂÓ ıÂˆÚÂ›Ù·È Ï¤ÔÓ fiÙÈ Â›Ó·È¤ÌÊ˘ÙÔ ̄ ·Ú·ÎÙËÚÈÛÙÈÎfi ‹ ÌfiÓÔÓ ·ÔÙ¤ÏÂÛÌ· ÂÌÂÈÚ›·˜.£ÂˆÚÂ›Ù·È ÈÎ·ÓfiÙËÙ· Ô˘ ‰È‰¿ÛÎÂÙ·È Î·È Ô˘ Ô ÏÂÈÙÔ˘Ú-Áfi˜ ÙË˜ ̆ ÁÂ›·˜ Ú¤ÂÈ Ó· ¤¯ÂÈ ÂÎ·È‰Â˘ÙÂ› ÁÈ’ ·˘Ù‹Ó. ™ÙËÓÔ˘Û›· ·ÔÙÂÏÂ› ÌÈ· ÛÂÈÚ¿ ·fi ‰ÂÍÈfiÙËÙÂ˜ Ô˘ Ì·ı·›ÓÔ-ÓÙ·È Î·È ‚ÂÏÙÈÒÓÔ˘Ó ÙËÓ ¤Î‚·ÛË ÙË˜ È·ÙÚÈÎ‹˜ ÊÚÔÓÙ›‰·˜.H ÂÌÂÈÚ›· ·fi ÌfiÓË ÙË˜ ‰ÂÓ Â·ÚÎÂ› ÁÈ· ÙËÓ ·fiÎÙËÛË·˘ÙÒÓ ÙˆÓ ‰ÂÍÈÔÙ‹ÙˆÓ17,21-23.H ÂÈÎÔÈÓˆÓ›· ÁÈ·ÙÚÔ‡-·ÛıÂÓ‹ ‚ÔËı¿ ÛÙË ÛˆÛÙ‹ Û˘Ï-ÏÔÁ‹ ÏËÚÔÊÔÚÈÒÓ ÁÈ· ÙË ÓfiÛÔ, Ù· Û˘ÌÙÒÌ·Ù·, ÙÈ˜ ÂÈ-ÏÔÎ¤˜ ·fi Ù· Ï·Ì‚·ÓfiÌÂÓ· Ê¿ÚÌ·Î· Î·È ıÂÚ·Â›Â˜ Î·ÈÛ˘Ì‚¿ÏÏÂÈ ÛÙË ÛˆÛÙ‹ ‰È¿ÁÓˆÛË Î·È ·ÓÙÈÌÂÙÒÈÛË. BÔË-ı¿ ÛÙËÓ ·fiÎÙËÛË ·˘ÙÔÓÔÌ›·˜ ÙÔ˘ ·ÛıÂÓ‹ Î·È ÛÙË Û˘Ì-ÌÂÙÔ¯‹ ÙÔ˘ ÛÙÔ ıÂÚ·Â˘ÙÈÎfi Û¯¤‰ÈÔ. ™˘Ì‚¿ÏÏÂÈ ÛÙËÓ Î·-Ï‡ÙÂÚË Û˘ÌÌfiÚÊˆÛË ÙÔ˘ ÛÙËÓ ÂÊ·ÚÌÔÁ‹ ÙË˜ Û˘ÓÈÛÙÒ-ÌÂÓË˜ ıÂÚ·Â›·˜ Î·È Ô‰ËÁÂ› ÛÂ ıÂÚ·Â˘ÙÈÎ‹ ·ÏÏËÏÂ›-‰Ú·ÛË ÌÂ ıÂÙÈÎ‹ Û˘Ì‚ÔÏ‹ ÛÙËÓ ›·ÛË. EÈÙ˘Á¯¿ÓÂÈ ÙË ‚ÂÏ-Ù›ˆÛË ÙÔ˘ „˘¯ÔÏÔÁÈÎÔ‡ ÂÚÈ‚¿ÏÏÔÓÙÔ˜, Ô˘ ÎÈÓÔ‡ÓÙ·È·ÛıÂÓ‹˜ Î·È ÁÈ·ÙÚfi˜, Û˘ÓÂÈÛÊ¤ÚÔÓÙ·˜ ÛÙËÓ ÈÎ·ÓÔÔ›Ë-ÛË Î·È ÙˆÓ ‰‡Ô Î·È ÛÙË ‚ÂÏÙ›ˆÛË ÙÔ˘ ·ÔÙÂÏ¤ÛÌ·ÙÔ˜ ÙË˜ıÂÚ·Â›·˜. K¿ÓÂÈ ÙÔ˘˜ ·ÛıÂÓÂ›˜ ÂÚÈÛÛfiÙÂÚÔ ÊÈÏÈÎÔ‡˜,ÂÈÎÔÈÓˆÓÈ·ÎÔ‡˜ Î·È Û˘ÓÂÚÁ¿ÛÈÌÔ˘˜ Î·È ÂÏ·ÙÙÒÓÂÈ ÙÈ˜ ‰È-Î·ÛÙÈÎ¤˜ ‰ÈÂÎ‰ÈÎ‹ÛÂÈ˜. ™‹ÌÂÚ· ıÂˆÚÂ›Ù·È fiÙÈ Ë ÂÈÎÔÈ-ÓˆÓ›· Â›Ó·È ÌÈ· ıÂÚ·Â˘ÙÈÎ‹ ÂÈÏÔÁ‹ Ô˘ ÌÔÚÂ› Î¿ÔÈ-Ô˜ Ó· ¯ÚËÛÈÌÔÔÈ‹ÛÂÈ1,17,21-23.

MH §EKTIKH E¶IKOINøNIAH ÌË ÏÂÎÙÈÎ‹ ÂÈÎÔÈÓˆÓ›· Â›Ó·È ¤Ó·˜ ¿ÏÏÔ˜ ‰›·˘ÏÔ˜ ÂÈ-ÎÔÈÓˆÓ›·˜ ÌÂ ÙÔÓ ·ÛıÂÓ‹. M¤Ûˆ ·˘Ù‹˜ ÂËÚÂ¿˙ÂÙ·È ËÛ˘ÌÂÚÈÊÔÚ¿, Ë ÓÔËÙÈÎ‹ Î·Ù¿ÛÙ·ÛË Î·È Ù· Û˘Ó·ÈÛı‹-Ì·Ù· ÙÔ˘ ÌÂ ÌË ÏÂÎÙÈÎÔ‡˜ ÙÚfiÔ˘˜. MËÓ‡Ì·Ù· ÌË ÏÂ-ÎÙÈÎ‹˜ ÂÈÎÔÈÓˆÓ›·˜ ÂÎ¤ÌÔ˘Ó Ô ÚÔÛ·Ó·ÙÔÏÈÛÌfi˜ Î·ÈË ÛÙ¿ÛË ÙÔ˘ ÛÒÌ·ÙÔ˜, ÔÈ ̄ ÂÈÚÔÓÔÌ›Â˜, ÔÈ ÎÈÓ‹ÛÂÈ˜, Ù· ·Á-Á›ÁÌ·Ù·, Ë ¤ÎÊÚ·ÛË ÙÔ˘ ÚÔÛÒÔ˘, ÙÔ Ì¤ÁÂıÔ˜ ÙÔ˘ ̇ ˆ-ÙÈÎÔ‡ ¯ÒÚÔ˘ Î·È Ë ÔÙÈÎ‹ Â·Ê‹. E›ÛË˜ Ô ÏfiÁÔ˜ ÂÌÂ-ÚÈ¤¯ÂÈ ÌË ÏÂÎÙÈÎ¿ ÛÙÔÈ¯Â›· ÂÈÎÔÈÓˆÓ›·˜, fiˆ˜ Ë ÔÈfi-ÙËÙ· ÙË˜ ÊˆÓ‹˜, Ô ÙfiÓÔ˜, Ë ¤ÓÙ·ÛË Î·È Ô ÙÚfiÔ˜ ÔÌÈ-Ï›·˜, Ë ·ÏÏÔ›ˆÛË, Ë ÛÙ·ıÂÚfiÙËÙ· ÙË˜ ÊˆÓ‹˜, ÔÈ ·‡-

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ÛÂÈ˜, Ë Ù·¯‡ÙËÙ· ÚÔ‹˜ ÙÔ˘ ÏfiÁÔ˘, Ë ‰È¿ÚÎÂÈ·, Ô Ú˘ıÌfi˜ÙÔ˘, Ë ÚÔÊÔÚ¿ Î·È ÔÈ ‰È¿ÊÔÚÔÈ ‹¯ÔÈ ÂÎÙfi˜ ÙˆÓ Ï¤ÍÂˆÓ.OÈ ÌË ÏÂÎÙÈÎÔ› ÙÚfiÔÈ ÂÈÎÔÈÓˆÓ›·˜ Â›Ó·È ÛËÌ·ÓÙÈÎfi ÎÔÌ-Ì¿ÙÈ ÙË˜ ÂÈÎÔÈÓˆÓ›·˜ ÌÂ ÙÔÓ ·ÛıÂÓ‹. T· ÌËÓ‡Ì·Ù· ÙË˜ÌË ÏÂÎÙÈÎ‹˜ ÂÈÎÔÈÓˆÓ›·˜ Ú¤ÂÈ Ó· Û˘Ì‚·‰›˙Ô˘Ó ÌÂ Ù·ÏÂÎÙÈÎ¿ ÌËÓ‡Ì·Ù· ÚÔ˜ ·˘ÙfiÓ. ¶Ú¤ÂÈ Ó· ̆ Ô‰ËÏÒÓÔ˘ÓÙ· ›‰È· Û˘Ó·ÈÛı‹Ì·Ù· Î·È Ó· ÌËÓ ¤Ú¯ÔÓÙ·È ÛÂ ·ÓÙ›Ê·ÛËÌÂÙ·Í‡ ÙÔ˘˜. ™Â ·ÛıÂÓÂ›˜ ÌÂ ·ÈÛıËÙËÚÈ·Î¿ ÚÔ‚Ï‹Ì·-Ù·, ‰˘ÛÎÔÏ›Â˜ ÛÙËÓ ÂÎÊÔÚ¿ ÙÔ˘ ÏfiÁÔ˘, „˘¯ÈÎ¤˜, ÓÔËÙÈ-Î¤˜ ‹ ÓÂ˘ÚÔÏÔÁÈÎ¤˜ ‰È·Ù·Ú·¯¤˜ Ë ÌË ÏÂÎÙÈÎ‹ ÂÈÎÔÈÓˆ-Ó›· ÌÔÚÂ› Ó· ·ÔÙÂÏÂ› ÙËÓ Î‡ÚÈ· ‹/Î·È ÙË ÌÔÓ·‰ÈÎ‹ Ô‰fiÂÈÎÔÈÓˆÓ›·˜1,21.

¶PO™TA™IA IATPIKOY A¶OPPHTOYH ÚÔÛÙ·Û›· ÙÔ˘ È·ÙÚÈÎÔ‡ ·fiÚÚËÙÔ˘ Â›Ó·È ·fi Ù· ·Ú-¯·ÈfiÙÂÚ· Î·ı‹ÎÔÓÙ· ÙÔ˘ ÁÈ·ÙÚÔ‡ ÚÔ˜ ÙÔÓ ·ÛıÂÓ‹. AÔ-ÙÂÏÂ› ÈÂÚ‹ ˘Ô¯Ú¤ˆÛË ÚÔ˜ ÙÔÓ ·ÛıÂÓ‹ Î·È ¤¯ÂÈ ·Ó·-ÊÔÚ¤˜ ÛÙË Û¯¤ÛË ÓÂ˘Ì·ÙÈÎÔ‡-ÈÛÙÔ‡. O ·ÛıÂÓ‹˜, fiÙ·Ó·ÔÎ·Ï‡ÙÂÈ ÛÙÔ ÁÈ·ÙÚfi ÚÔÛˆÈÎ¿ ÙÔ˘ ÛÙÔÈ¯Â›·, ÙÔ˘ÌÂÙ·‚È‚¿˙ÂÈ ¤Ó· ÌÂÁ¿ÏÔ Ì¤ÚÔ˜ ÙË˜ ·˘ÙÔÓÔÌ›·˜ ÙÔ˘ Î·È·˘Ù‹ Ë ÚÔÛÊÂÚfiÌÂÓË ·˘ÙÔÓÔÌ›· Ú¤ÂÈ Ó· ‰È·Ê˘Ï·-¯ıÂ›. O ŸÚÎÔ˜ ÙÔ˘ IÔÎÚ¿ÙË Â›Ó·È ÙÔ ÚÒÙÔ ÁÚ·ÙfiÎÂ›ÌÂÓÔ ÌÂ ·Ó·ÊÔÚ¿ ÛÙÔ È·ÙÚÈÎfi ·fiÚÚËÙÔ. I·ÙÚÈÎfi ·fiÚ-ÚËÙÔ Â›Ó·È Î¿ıÂ ÁÂÁÔÓfi˜ Ô˘ Â›Ó·È ÁÓˆÛÙfi ÛÂ ÂÚÈÔÚÈ-ÛÌ¤ÓÔ ÌfiÓÔ Î‡ÎÏÔ ·ÙfiÌˆÓ, Ù· ÔÔ›· ¤¯Ô˘Ó Û˘ÌÊ¤ÚÔÓ ‹ÂÈı˘ÌÔ‡Ó Ó· ·Ú·ÌÂ›ÓÂÈ ÁÓˆÛÙfi ÌfiÓÔ ÛÂ ·˘Ù¿. K·ıÂÙ›Ô˘ ÂÌÈÛÙÂ‡ÂÙ·È Ô ·ÛıÂÓ‹˜ ÛÙÔ ÁÈ·ÙÚfi ‹ ÛÙÔ ÓÔÛË-ÏÂ˘Ù‹. K·ıÂÙ› Ô˘ Ô ÁÈ·ÙÚfi˜ ‹ Ô ÓÔÛËÏÂ˘Ù‹˜ ÏËÚÔÊÔ-Ú‹ıËÎÂ, Û˘Ì¤Ú·ÓÂ, ˘¤ıÂÛÂ ‹ ·ÓÙÈÏ‹ÊıËÎÂ. OÔÈ·‰‹-ÔÙÂ ıÂÙÈÎ‹ ‹ ·ÚÓËÙÈÎ‹ ‰È·›ÛÙˆÛË. K¿ıÂ ÏËÚÔÊÔÚ›·,ÌÂÈˆÙÈÎ‹ ‹ fi¯È. K¿ıÂ ÏËÚÔÊÔÚ›· Ô˘ Ô ·ÛıÂÓ‹˜ ‰ÂÓ ı¤-ÏÂÈ Ó· ÁÓˆÛÙÔÔÈËıÂ› ·ÎfiÌ· Î·È ·Ó ÊËÌÔÏÔÁÂ›Ù·È. AÎfi-Ì· Î·È Ë Â›ÛÔ‰Ô˜ ÙÔ˘ ·ÛıÂÓ‹ ÛÙÔ È·ÙÚÂ›Ô ‹ ÛÙË ÓÔÛË-ÏÂ˘ÙÈÎ‹ ÌÔÓ¿‰·24.O Ô‰ÔÓÙ›·ÙÚÔ˜ ¤¯ÂÈ ËıÈÎ‹ Î·È ÓÔÌÈÎ‹ ̆ Ô¯Ú¤ˆÛË Ó· ÚÔ-ÛÙ·ÙÂ‡ÂÈ ÙÔ ·fiÚÚËÙÔ ÙÔ˘ ·ÛıÂÓ‹. H ÚÔÛÙ·Û›· ÙÔ˘ È·-ÙÚÈÎÔ‡ ·fiÚÚËÙÔ˘ Â›Ó·È ‚·ÛÈÎfi Û˘ÛÙ·ÙÈÎfi ÙË˜ Û¯¤ÛË˜ÂÌÈÛÙÔÛ‡ÓË˜ ÌÂÙ·Í‡ Ô‰ÔÓÙ›·ÙÚÔ˘ Î·È ·ÛıÂÓ‹. AÊÔÚ¿fiÏ· Ù· Ì¤ÏË ÙË˜ Ô‰ÔÓÙÈ·ÙÚÈÎ‹˜ ÔÌ¿‰·˜ Î·È fiÏÂ˜ ÙÈ˜ ÏË-ÚÔÊÔÚ›Â˜ Ô˘ ·ÔÎ·Ï‡ÊıËÎ·Ó ·fi ÙÔÓ ·ÛıÂÓ‹ ÛÙÔ Ï·›-ÛÈÔ ÙË˜ Â·ÁÁÂÏÌ·ÙÈÎ‹˜ ÙÔ˘ Û¯¤ÛË˜ ÌÂ ÙÔÓ Ô‰ÔÓÙ›·ÙÚÔ.OÈ ÏËÚÔÊÔÚ›Â˜ ·˘Ù¤˜ ÚÔÛÙ·ÙÂ‡ÔÓÙ·È ·ÎfiÌ· Î·È ÌÂÙ¿ÙÔ ı¿Ó·ÙÔ ÙÔ˘ ·ÛıÂÓ‹2,14,25,26.

¶EPIºPOYPH™H KAI ¶PO™TA™IA TøN AN£Pø¶INøN¢IKAIøMATøN TOY A™£ENHAÛÎÒÓÙ·˜ ÙËÓ Ô‰ÔÓÙÈ·ÙÚÈÎ‹ ÛÂ ÓÔÛÔÎÔÌÂ›Ô, Ô Ô‰ÔÓÙ›·-ÙÚÔ˜ ı· ÎÏËıÂ› Ó· ·ÓÙÈÌÂÙˆ›ÛÂÈ ‹ Î·È Ó· ÓÔÛËÏÂ‡ÛÂÈÎÚ·ÙÔ‡ÌÂÓÔ˘˜, ˘fi‰ÈÎÔ˘˜ ‹ ·È¯Ì·ÏÒÙÔ˘˜. ™ÙÈ˜ ÂÚÈ-ÙÒÛÂÈ˜ ·˘Ù¤˜, Ô Ô‰ÔÓÙ›·ÙÚÔ˜ Â›Ó·È Ô ÂÁÁ˘ËÙ‹˜ ÙˆÓ ıÂ-ÌÂÏÈˆ‰ÒÓ ·ÓıÚÒÈÓˆÓ ‰ÈÎ·ÈˆÌ¿ÙˆÓ ÙÔ˘ ·ÛıÂÓ‹ Î·È ¤¯ÂÈÙËÓ Â˘ı‡ÓË ÙË˜ ÚÔÛÙ·Û›·˜ ÙÔ˘˜ ·fi ·˘ı·ÈÚÂÛ›Â˜ Î·ÈÎ·Ù¿¯ÚËÛË ÂÍÔ˘Û›·˜3.

™EBA™MO™ ™TI™ ¶E¶OI£H™EI™ TOY A™£ENHO Ô‰ÔÓÙ›·ÙÚÔ˜ ÔÊÂ›ÏÂÈ Ó· Û¤‚ÂÙ·È ÙÈ˜ ÂÔÈı‹ÛÂÈ˜ ÙÔ˘ ÓÔ-

ÛËÏÂ˘fiÌÂÓÔ˘ ·ÛıÂÓ‹ Î·È Ó· Î¿ÓÂÈ fiÙÈ Â›Ó·È ‰˘Ó·ÙfiÓ ÁÈ· Ó·ÚÔÛ·ÚÌfiÛÂÈ ÛÂ ·˘Ù¤˜ ÙË ıÂÚ·Â˘ÙÈÎ‹ ÙÔ˘ Ù·ÎÙÈÎ‹. OÊÂ›-ÏÂÈ Ó· ÛÂ‚·ÛÙÂ› ÙËÓ ¿Ô„Ë ÙÔ˘ ·ÛıÂÓ‹ (¯ ÁÈ· ÌË ÌÂÙ¿Á-ÁÈÛË) Î·È Ó· ÂÍ·ÓÙÏ‹ÛÂÈ fiÏ· Ù· ‰È·ı¤ÛÈÌ· Ì¤Û· (·˘ÙÔÌÂ-Ù¿ÁÁÈÛË, ˘ÔÎ·Ù¿ÛÙ·Ù· fiÁÎÔ˘ ÙÔ˘ ·›Ì·ÙÔ˜ ÎÏ) ÚÔÎÂÈ-Ì¤ÓÔ˘ Ó· Á›ÓÔ˘Ó ÛÂ‚·ÛÙ¤˜ ÔÈ ·ÓÙÈÚÚ‹ÛÂÈ˜ ÙÔ˘. AÓ ‚ÚÂıÂ›ÛÂ ·ÎÚ·›Â˜ Û˘Óı‹ÎÂ˜ Î·È È‰È·›ÙÂÚ· ÛÂ Û˘Óı‹ÎÂ˜ Ô˘ ·ÂÈ-ÏÂ›Ù·È Ë ·ÓıÚÒÈÓË ˙ˆ‹, ÌÔÚÂ› Ó· Î·Ù·Ê‡ÁÂÈ ÛÙË Û˘Ì-‚Ô˘Ï‹ ÔÚÁ¿ÓˆÓ ÚÔÛÙ·Û›·˜ ÙˆÓ ·ÓıÚÒÈÓˆÓ ‰ÈÎ·ÈˆÌ¿-ÙˆÓ (™˘Ó‹ÁÔÚÔ˜ ÙÔ˘ ¶ÔÏ›ÙË, AÚ¯‹ ÚÔÛÙ·Û›·˜ AÓıÚÒÈ-ÓˆÓ ‰ÈÎ·ÈˆÌ¿ÙˆÓ ÎÏ) Ë ÛÙÈ˜ ÂÈÛ·ÁÁÂÏÈÎ¤˜ ·Ú¯¤˜3.

E¶I™HMAN™EI™ °IA EI¢IKE™ KATH°OPIE™ A™£ENøNOÈ ·Ú·¿Óˆ ·Ú¯¤˜ ·ÔÙÂÏÔ‡Ó ¤Ó· Ï·›ÛÈÔ ·ÓÙÈÏ‹„ÂˆÓÌÂ ÂÊ·ÚÌÔÁ‹ ÛÂ Î¿ıÂ Ô‰ÔÓÙÈ·ÙÚÈÎfi ·ÛıÂÓ‹. H Ù‹ÚËÛËÙˆÓ ·Ú¯ÒÓ ·˘ÙÒÓ ¤¯ÂÈ È‰È·›ÙÂÚË ÛËÌ·Û›· fiÙ·Ó ·ÓÙÈÌÂ-Ùˆ›˙ÂÙ·È ·ÛıÂÓ‹˜ ÌÂ Û˘ÛÙËÌ·ÙÈÎ¿ ÓÔÛ‹Ì·Ù·, ·Ó·ËÚ›·,ÓÔËÙÈÎ‹ ˘ÛÙ¤ÚËÛË, Î·Ù¿ ÙËÓ ¿ÛÎËÛË O‰ÔÓÙÈ·ÙÚÈÎ‹˜ EÈ-‰ÈÎ‹˜ ºÚÔÓÙ›‰·˜ ÛÙÔ NÔÛÔÎÔÌÂ›Ô. O ¯ÚÔÓ›ˆ˜ ¿Û¯ˆÓ, Ô Î·ÚÎÈÓÔ·ı‹˜, Ô ÓÂ˘ÚÔÏÔÁÈÎfi˜, Ô„˘¯È·ÙÚÈÎfi˜, Ô ·ÛıÂÓ‹˜ ÌÂ ÏÔÈÌÒ‰Ë ÓÔÛ‹Ì·Ù·, ¤¯Ô˘Ó·ÎfiÌ· ÌÂÁ·Ï‡ÙÂÚË ·Ó¿ÁÎË ÂÓÛ˘Ó·›ÛıËÛË˜, ÛÂ‚·ÛÌÔ‡ÙË˜ ·˘ÙÔÓÔÌ›·˜, ‚ÂÏÙ›ˆÛË˜ ÙË˜ ÂÈÎÔÈÓˆÓ›·˜, ÚÔÛÙ·-Û›·˜ ÙÔ˘ È·ÙÚÈÎÔ‡ ·ÔÚÚ‹ÙÔ˘. ™ÙÔÓ ·ÛıÂÓ‹ ÌÂ ·ÈÛıËÙË-ÚÈ·Î¤˜ ‰˘ÛÏÂÈÙÔ˘ÚÁ›Â˜, ‰˘ÛÊ·Û›·, ÓÂ˘ÚÔÏÔÁÈÎ¤˜ ‹ „˘-¯ÈÎ¤˜ ‰È·Ù·Ú·¯¤˜, Ë ÌË ÏÂÎÙÈÎ‹ ÂÈÎÔÈÓˆÓ›· ·ÔÎÙ¿ ·Îfi-Ì· ÌÂÁ·Ï‡ÙÂÚË ÛËÌ·Û›·, ÂÓÒ ÛÂ ÔÚÈÛÌ¤ÓÂ˜ ÂÚÈÙÒÛÂÈ˜ÌÔÚÂ› Ó· Â›Ó·È Ë ÌÔÓ·‰ÈÎ‹ Ô‰fi˜ ÂÈÎÔÈÓˆÓ›·˜. ¢ÂÓ Â›Ó·È‰˘Ó·ÙfiÓ Ó· ÊÙÈ·¯ÙÔ‡Ó ÂÈ‰ÈÎ¤˜ Ô‰ËÁ›Â˜ ÁÈ· Î¿ıÂ Î·ÙËÁÔ-Ú›· ·ÛıÂÓÒÓ. MÂ Â˘·ÈÛıËÛ›·, ÏÂÙfiÙËÙ· Î·È ÂÓ‰È·Ê¤ÚÔÓÁÈ· ÙÔÓ ¿ÓıÚˆÔ, ÔÈ ·Ú¯¤˜ Ô˘ ÚÔËÁÔ˘Ì¤Óˆ˜ ·Ó·Ê¤Ú-ıËÎ·Ó ÂÍ·ÙÔÌÈÎÂ‡ÔÓÙ·È ÁÈ· Î¿ıÂ ·ÛıÂÓ‹. EÓ‰ÂÈÎÙÈÎ¿ ·Ó·-Ê¤ÚÔÓÙ·È ·Ú·Î¿Ùˆ ·Ú·ÙËÚ‹ÛÂÈ˜ ÁÈ· ÙËÓ ÂÈÎÔÈÓˆÓ›·ÌÂ ÂÈ‰ÈÎ¤˜ Î·ÙËÁÔÚ›Â˜ ·ÛıÂÓÒÓ. OÈ Î·ÚÎÈÓÔ·ıÂ›˜ Â›Ó·È ÔÏ‡ Ù·Ï·ÈˆÚËÌ¤ÓÔÈ ·ÛıÂÓÂ›˜.™˘Ó‹ıˆ˜ ÔÈ ·ÏÏÂ¿ÏÏËÏÂ˜ ÂÂÌ‚¿ÛÂÈ˜ Î·È ıÂÚ·Â›Â˜ Ô˘¤¯Ô˘Ó ̆ Ô‚ÏËıÂ› ¤¯Ô˘Ó ‹‰Ë ÙÚ·˘Ì·Ù›ÛÂÈ ÙËÓ ÂÈÎfiÓ· ÙÔ˘˜.H ·Ó¿ÁÎË ÂÍ·ÁˆÁÒÓ, ÛÙÈ˜ ÔÔ›Â˜ Èı·ÓfiÓ Ú¤ÂÈ Ó· ̆ Ô-‚ÏËıÔ‡Ó, Â›Ó·È ÂÈÏ¤ÔÓ ·ÎÚˆÙËÚÈ·ÛÌfi˜, Ô˘ ı· ÚÔ-Î·Ï¤ÛÂÈ ÚfiÛıÂÙË ‰˘ÛÌÔÚÊ›· Î·È ÂÈÏ¤ÔÓ „˘¯ÈÎfi fi-ÓÔ. K·Ù¿ ÙËÓ ·ÓÙÈÌÂÙÒÈÛË ÙÔ˘˜ ¯ÚÂÈ¿˙ÂÙ·È ÏÂÙfiÙËÙ·,ÂÓÛ˘Ó·›ÛıËÛË, ÛÂ‚·ÛÌfi˜ ÙË˜ ·˘ÙÔÓÔÌ›·˜ ÙÔ˘˜, ·ÔÊ˘-Á‹ ‰ËÌÈÔ˘ÚÁ›·˜ ÂÓÔ¯ÒÓ, ÂÛÙ›·ÛË ÛÙ· ÚÔÛ‰ÔÎÒÌÂÓ· ÔÊ¤-ÏË ÙË˜ ·ÓÙÈÌÂÙÒÈÛË˜. EÈ‰ÈÎ‹ Î·ÙËÁÔÚ›· ÙˆÓ Î·ÚÎÈÓÔ·ıÒÓ ·ÛıÂÓÒÓ Â›Ó·È ÔÈ·ÛıÂÓÂ›˜ ÌÂ ÙÚ·¯ÂÈÔÛÙÔÌ›·. H ‰˘ÛÎÔÏ›· ÛÙËÓ ÂÈÎÔÈÓˆ-Ó›· ÌÂ ÙÔ˘˜ ·ÛıÂÓÂ›˜ ·˘ÙÔ‡˜ Â›Ó·È ‰Â‰ÔÌ¤ÓË. H ‰˘ÛÎÔ-Ï›· ·˘Ù‹ ‰ÂÓ Ú¤ÂÈ Ó· Ô‰ËÁÂ› ÛÂ ·ÁÓfiËÛË ‹ ·Ú¿Î·Ì-„‹ ÙÔ˘˜ Î·È Û˘ÓÂÓÓfiËÛË ÌÂ ÙÔ˘˜ Û˘ÓÔ‰Ô‡˜ ÙÔ˘˜. A˘Ùfiı· ÈÛÔ‰˘Ó·ÌÔ‡ÛÂ ÌÂ Ï‹ÚË Î·Ù¿ÚÁËÛË ÙË˜ ·˘ÙÔÓÔÌ›·˜ÙÔ˘˜ Î·È ·ÓÙÈÌÂÙÒÈÛË ÙÔ˘˜ Û· Ó· Â›Ó·È ‹‰Ë ÓÂÎÚÔ›. K·ÈÛÂ ·˘Ù‹ ÙËÓ ÂÚ›ÙˆÛË Ë ÂÓËÌ¤ÚˆÛË Á›ÓÂÙ·È Î·ÙÂ˘ıÂ›-·Ó ÛÙÔÓ ·ÛıÂÓ‹, ÍÂÎ¿ı·Ú· Î·È ÎÔÈÙ¿˙ÔÓÙ·˜ ÙÔÓ ÛÙ· Ì¿-ÙÈ·. K·È ÛÂ ·˘Ù‹ ÙËÓ ÂÚ›ÙˆÛË ÔÈ ·ÔÊ¿ÛÂÈ˜ Ï·Ì‚¿ÓÔ-ÓÙ·È ·fi ÙÔÓ ·ÛıÂÓ‹. EÍ·›ÚÂÛË ‰ÈÎ·ÈÔÏÔÁÂ›Ù·È ÌfiÓÔÓ ·ÓÔ ›‰ÈÔ˜ ‰ÂÓ ÙÔ ÂÈı˘ÌÂ› Î·È ·Ú·¤ÌÂÈ ÛÙÔ˘˜ ÔÈÎÂ›Ô˘˜ÙÔ˘. OÈ ·ÛıÂÓÂ›˜ ÌÂ AÁÁÂÈ·Îfi EÁÎÂÊ·ÏÈÎfi EÂÈÛfi‰ÈÔ (AEE) Î·È

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·ÈÛıËÙËÚÈ·Î¤˜ ‰È·Ù·Ú·¯¤˜ ‹/Î·È ÚÔ‚Ï‹Ì·Ù· ÛÙËÓ ÂÎ-ÊÔÚ¿ ÙÔ˘ ÏfiÁÔ˘ ¯ÚÂÈ¿˙ÔÓÙ·È Ì¤ÙÚ· ˘Ô‚Ô‹ıËÛË˜ ÙË˜ÂÈÎÔÈÓˆÓ›·˜. H Û˘ÓÔÌÈÏ›· Ì·˙› ÙÔ˘˜ Ú¤ÂÈ Ó· Á›ÓÂÙ·È¯ˆÚ›˜ Ì¿ÛÎ· ÚÔÛÒÔ˘, ÁÈ· Ó· ÌÔÚÔ‡Ó Ó· ‰È·‚¿ÛÔ˘ÓÙ· ¯Â›ÏË. OÈ ÚÔÙ¿ÛÂÈ˜ Ô˘ ¯ÚËÛÈÌÔÔÈÔ‡ÓÙ·È Ú¤ÂÈ Ó·Â›Ó·È Û‡ÓÙÔÌÂ˜, ·Ï¤˜ Î·È Ó· ÌÔÚÔ‡Ó Ó· ··ÓÙËıÔ‡ÓÌÔÓÔÏÂÎÙÈÎ¿. ¶Ú¤ÂÈ Ó· ‰›‰ÂÙ·È ̄ ÚfiÓÔ˜ ÛÙÔÓ ·ÛıÂÓ‹ ÁÈ·Ó· Û¯ËÌ·Ù›ÛÂÈ Î·È Ó· ÂÎÊ¤ÚÂÈ ÙËÓ ·¿ÓÙËÛË ÙÔ˘, ‰È·ÊÔ-ÚÂÙÈÎ¿ ÌÔÚÂ› Ó· ÌËÓ ÚÔÏ¿‚ÂÈ Ó· ··ÓÙ‹ÛÂÈ. ™ÙË ‰È¿Ú-ÎÂÈ· ÙË˜ ÂÈÎÔÈÓˆÓ›·˜ Ú¤ÂÈ Ó· ÂÈÎÚ·ÙÂ› ËÚÂÌ›· ÛÙÔ ̄ Ò-ÚÔ ÙÔ˘ È·ÙÚÂ›Ô˘, Î·ıÒ˜ Î·È ÛÙÈ˜ ÎÈÓ‹ÛÂÈ˜ Î·È ÛÙÔ ÏfiÁÔÙÔ˘ Ô‰ÔÓÙÈ¿ÙÚÔ˘. O ÙfiÓÔ˜ Î·È Ë ¤ÓÙ·ÛË ÙË˜ ÊˆÓ‹˜ ÙÔ˘Ô‰ÔÓÙÈ¿ÙÚÔ˘ Î·È ÙÔ˘ ÚÔÛˆÈÎÔ‡ ÙÔ˘ È·ÙÚÂ›Ô˘ Ú¤ÂÈ Ó·Â›Ó·È ̄ ·ÌËÏfi˜, ̄ ˆÚ›˜ ÚÔÛÙ·ÙÂ˘ÙÈÎ‹ ̄ ÚÔÈ¿. ™Â Î·ÌÈ¿ Â-Ú›ÙˆÛË ‰ÂÓ ÂÈÙÚ¤ÂÙ·È Ë ÌˆÚÔ˘‰›ÛÙÈÎË ÔÌÈÏ›·. H ÌËÏÂÎÙÈÎ‹ ÂÈÎÔÈÓˆÓ›· ·›˙ÂÈ ÛÔ˘‰·›Ô ÚfiÏÔ ÛÙËÓ ÂÈÎÔÈ-ÓˆÓ›· ÌÂ ÙÔÓ ·ÛıÂÓ‹. H ÔÙÈÎ‹ Â·Ê‹, ÙÔ ¯·ÌfiÁÂÏÔ, Ë¤ÎÊÚ·ÛË ÙÔ˘ ÚÔÛÒÔ˘, Ë ÁÏÒÛÛ· ÙÔ˘ ÛÒÌ·ÙÔ˜, ÙÔ ¿Á-ÁÈÁÌ· ‹ ¿ÏÏÂ˜ Û˘ÓÂÈ‰ËÙ¤˜ ¯ÂÈÚÔÓÔÌ›Â˜, Â›Ó·È ÂÍ·›ÚÂÙÔÈÙÚfiÔÈ ÌË ÏÂÎÙÈÎ‹˜ ÂÈÎÔÈÓˆÓ›·˜ ÌÂ ÙÔÓ ·ÛıÂÓ‹28.AÚÎÂÙÔ› ·ÛıÂÓÂ›˜ ̆ fi ·ÓÙÈÂÈÏËÙÈÎ‹ ·ÁˆÁ‹ ÂÍ·ÈÙ›·˜ ÙË˜·ÁˆÁ‹˜ ÙÔ˘˜ ¤¯Ô˘Ó ‚Ú·‰‡ÙËÙ· ÛÙËÓ ·ÁˆÁ‹ ÙÔ˘ ÂÚÂı›-ÛÌ·ÙÔ˜ Î·È ÁÈ’ ·˘Ùfi ·ÚÁÔ‡Ó Ó· ··ÓÙ‹ÛÔ˘Ó4. XÚÂÈ¿˙Ô-ÓÙ·È ̄ ÚfiÓÔ ÁÈ· Ó· Û¯ËÌ·Ù›ÛÔ˘Ó Î·È Ó· ÂÎÊ¤ÚÔ˘Ó ÙËÓ ·¿-ÓÙËÛË ÙÔ˘˜, Ô ÔÔ›Ô˜ Ú¤ÂÈ Ó· ÙÔ˘˜ ·Ú¤¯ÂÙ·È, ‰È·ÊÔ-ÚÂÙÈÎ¿ ‰ÂÓ ı· ÚÔÏ¿‚Ô˘Ó Ó· ··ÓÙ‹ÛÔ˘Ó ÔÙ¤. ™ÙÔ˘˜ ·ÛıÂÓÂ›˜ ÌÂ „˘¯ÔÎÈÓËÙÈÎ‹ ˘ÛÙ¤ÚËÛË Ë ÂÈÎÔÈÓˆ-Ó›· ÚÔÛ·ÚÌfi˙ÂÙ·È ·Ó¿ÏÔÁ· ÌÂ ÙËÓ Î·Ù¿ÛÙ·ÛË ÙÔ˘˜.EÊfiÛÔÓ Ë ÏÂÎÙÈÎ‹ ÂÈÎÔÈÓˆÓ›· Â›Ó·È ‰˘Ó·Ù‹ Ô ÏfiÁÔ˜ Ú¤-ÂÈ Ó· Â›Ó·È ·Ïfi˜ Î·È Ù· ÌËÓ‡Ì·Ù· Û·Ê‹ Î·È Î·Ù·ÓÔË-Ù¿. ¶ÚÔ¤¯ÂÈ Ë Î·ıËÛ‡¯·Û‹ ÙÔ˘˜. H ÔÙÈÎ‹ Â·Ê‹, ÙÔ ̄ ·-ÌfiÁÂÏÔ Î·È ÙÔ ¿ÁÁÈÁÌ· Â›Ó·È ÂÍ·›ÚÂÙÔÈ ÙÚfiÔÈ ÌË ÏÂÎÙÈ-Î‹˜ ÂÈÎÔÈÓˆÓ›·˜. ™ÙÔ˘˜ „˘¯È·ÙÚÈÎÔ‡˜ ·ÛıÂÓÂ›˜ ÚÔ¤¯ÂÈ Ë Î·ıËÛ‡¯·ÛË Î·ÈÔ Î·ÙÂ˘Ó·ÛÌfi˜ ÙÔ˘ ¿Á¯Ô˘˜ ÙÔ˘˜. XÚÂÈ¿˙ÂÙ·È Ó· ÙÔ˘˜ ‰›-ÓÂÙ·È Ô ¯ÚfiÓÔ˜ Î·È Ë ‰˘Ó·ÙfiÙËÙ· Ó· Ô˘Ó ·˘Ùfi Ô˘ ·È-Ûı¿ÓÔÓÙ·È28. ¶Ú¤ÂÈ Ó· Î·Ù·‚¿ÏÏÂÙ·È ÚÔÛ¿ıÂÈ· ¿Ì-‚Ï˘ÓÛË˜ ÙˆÓ ÂÓÔ¯ÒÓ ÙÔ˘˜. T· ÌËÓ‡Ì·Ù· Ô˘ ÌÂÙ·‰›‰Ô-ÓÙ·È ·fi ÙÔÓ Ô‰ÔÓÙ›·ÙÚÔ Ó· Â›Ó·È ÍÂÎ¿ı·Ú· Î·È Ó· ÌËÓÂ›Ó·È ÔÙ¤ ‰ÈÊÔÚÔ‡ÌÂÓ· ÁÈ· Ó· ÌËÓ ÙÔ˘˜ ‰ËÌÈÔ˘ÚÁÔ‡ÓÛ‡Á¯˘ÛË.

™YM¶EPA™MATIKAH Û‡Á¯ÚÔÓË ¿ÛÎËÛË ÙË˜ Ô‰ÔÓÙÈ·ÙÚÈÎ‹˜ ÚÔ¸Ôı¤ÙÂÈ ÙËÛˆÛÙ‹ ‰È¿ÁÓˆÛË Î·È ÙËÓ ÂÂÍÂÚÁ·Û›· Î·È ÂÎÙ¤ÏÂÛË ÂÓfi˜ÛˆÛÙÔ‡ Û¯Â‰›Ô˘ ıÂÚ·Â›·˜. TË ÁÓÒÛË ÙÔ˘ È·ÙÚÈÎÔ‡ ÈÛÙÔ-ÚÈÎÔ‡ ÙÔ˘ ·ÛıÂÓ‹ Î·È ÙËÓ ÂÊ·ÚÌÔÁ‹ ÙˆÓ ·Ó·ÁÎ·›ˆÓ ÙÚÔ-ÔÔÈ‹ÛÂˆÓ ÙÔ˘ ÚˆÙfiÎÔÏÏÔ˘ ·ÓÙÈÌÂÙÒÈÛË˜, ÁÈ· ÙËÓ·ÛÊ¿ÏÂÈ· ÙÔ˘. ŸÌˆ˜, ÂÎÙfi˜ ·fi Ù· ·Ú·¿Óˆ Î·È Û‡Ì-ÊˆÓ· ÌÂ ÙÈ˜ Û‡Á¯ÚÔÓÂ˜ ·fi„ÂÈ˜, Ë Ô‰ÔÓÙÈ·ÙÚÈÎ‹ Û‹ÌÂ-Ú· Ú¤ÂÈ Ó· ·ÛÎÂ›Ù·È Ì¤Û· ÛÂ ¤Ó· Ï·›ÛÈÔ ËıÈÎÒÓ Î·-ÓfiÓˆÓ Ô˘ Ó· ı¤ÙÔ˘Ó ÙÔÓ ·ÛıÂÓ‹ ÛÙÔ Â›ÎÂÓÙÚÔ. ¶Ú¤ÂÈÓ· ÂÍ·ÛÊ·Ï›˙ÂÈ ÙÔ ÛÂ‚·ÛÌfi ÙË˜ ·ÙÔÌÈÎfiÙËÙ·˜ Î·È ÙË˜·ÍÈÔÚ¤ÂÈ·˜ ÙÔ˘ ·ÛıÂÓ‹. ™ÙË ‰È¿ÚÎÂÈ· ÙË˜ ıÂÚ·Â˘ÙÈ-Î‹˜ Û¯¤ÛË˜ Ó· ·Ó·Ù‡ÛÛÂÙ·È ÂÓÛ˘Ó·›ÛıËÛË ÁÈ’ ·˘ÙfiÓ,Ó· ÂÍ·ÛÊ·Ï›˙ÂÙ·È Ô ÛÂ‚·ÛÌfi˜ ÙË˜ ·˘ÙÔÓÔÌ›·˜ ÙÔ˘, Ë Û˘-ÁÎ·Ù¿ıÂÛ‹ ÙÔ˘ ÁÈ· ıÂÚ·Â›Â˜ Î·È ÂÂÌ‚¿ÛÂÈ˜, Ë ÚÔ-ÛÙ·Û›· ÙÔ˘ È·ÙÚÈÎÔ‡ ·fiÚÚËÙÔ˘, Ë ÚÔÛÙ·Û›· ÙˆÓ ·ÙÔ-

ÌÈÎÒÓ ÙÔ˘ ‰ÈÎ·ÈˆÌ¿ÙˆÓ Î·È Ô ÛÂ‚·ÛÌfi˜ ÙˆÓ È‰È·›ÙÂÚˆÓÂÔÈı‹ÛÂˆÓ ÙÔ˘. MÂ È‰È·›ÙÂÚË ÚÔÛÔ¯‹, ÏÂÙfiÙËÙ· Î·ÈÂ˘·ÈÛıËÛ›· Ú¤ÂÈ ÔÈ ·Ú¯¤˜ ·˘Ù¤˜ Ó· ÂÊ·ÚÌfi˙ÔÓÙ·È ÛÙÔ˘˜·ÛıÂÓÂ›˜ ÌÂ Û˘ÛÙËÌ·ÙÈÎ¿ ÓÔÛ‹Ì·Ù·.

SUMMARY

Improving the dentist-patient relationship.Emphasizing to special needs patient.

Bogosian E.


The academic interest about doctor-patient relationshiphas been increased in recent decades, as it became clearthat the therapeutic relationship is an integral part oftreatment and effective medical intervention and care.The goal is to improve the relationship and achieve abetter therapeutic effect and greater doctor/dentist andpatient satisfaction. The purpose of this paper is to presenta framework for dentist-patient relationship in order tomake it better emphasizing to special needs patient.The right feeling for the patient is empathy. Empathy isthe ability of someone to share the feelings of another.The understanding, awareness, sensitivity, perception ofemotions, thoughts and experiences of another, withouthaving the feelings, thoughts and experiences fullycommunicated in an objectively explicit manner. The principle of autonomy (self-governance) refers to thepeople’s right to make their own choices about healthand treatment, based on their own personal values andbeliefs. It also refers to the patients’ right for respect totheir individuality and dignity. During the therapeuticrelationship patients should feel that they are supportedand have not lost control. The dentist has the duty torespect the patient’s rights to self-determination, to treatthe patient according to his desires, within the bounds ofaccepted treatment. It is dentist’s primary obligations toinvolve patient in treatment decisions in a meaningful way,with due consideration being given to the patient’s needs,desires and abilities. Receiving informed consent toproposed treatment and surgery supports the principleof patients’ autonomy.Confidentiality is the ethical principle or legal right that aphysician or other health professional will hold secret allinformation relating to a patient, unless the patient givesconsent permitting disclosure. Confidentiality is the rightof an individual to have personal, identifiable medicalinformation kept private. Such information should beavailable only to the physician of record and other healthcare and insurance personnel as necessary. Although the above principles apply to every dental patient,their application is of particular importance when treatingpatients with systemic diseases, disabilities, mental retardation,in the exercise of Special Care Dentistry at the Hospital.

Key words: Dentist-patient relationship; empathy;autonomy; communication; confidentiality

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BIB§IO°PAºIA1. §ÈÔÓ‹˜ X: ™¯¤ÛË I·ÙÚÔ‡-AÛıÂÓÔ‡˜: O‰ËÁ›Â˜ ÁÈ· ÌÈ· ·ÔÙÂ-

ÏÂÛÌ·ÙÈÎ‹ ÂÈÎÔÈÓˆÓ›·. 2011 http://doctor-patient.med.uoc.gr/arxeia/simeioseis_doctor-patient.pdf,(fiˆ˜ ÂÌÊ·Ó›˙ÂÙ·È ÛÙÈ˜ 29/12/2011).

2. Yeager AL: Dental ethics for the 21st Century: Learning fromthe Charter on Medical Professionalism. J Am Coll Dent 2002;69(3):53-60.

3. O ÊÔÈÙËÙ‹˜ ÌÚÔÛÙ¿ ÛÙÔ ¯ÂÈÚÔ˘ÚÁÈÎfi ·ÛıÂÓ‹.http://eclass.uoa.gr//modules/link/link.php?course=MED207

(fiˆ˜ ÂÌÊ·Ó›˙ÂÙ·È ÛÙÈ˜ 29/3/2012).4. Malamed SF: Medical Emergencies in the Dental Office. 6th

ed. St. Louis. Mosby. 2007: 47.5. Larson EB, Yao X: Clinical Empathy as Emotional Labor in

the Patient-Physician Relationship. JAMA 2005; 293(9): 1100-1106.

6. Halpern J: Empathy and Patient-Physician Conflicts. J GenIntern Med 2007; 22(5): 696-700.

7. Halpern J: What is Clinical Empathy? J Gen Intern Med 2003;18(8): 670-674.

8. EıÓÈÎ‹ EÈÙÚÔ‹ BÈÔËıÈÎ‹˜: °ÓÒÌË. ™˘Ó·›ÓÂÛË ÛÙË Û¯¤ÛËI·ÙÚÔ‡ - AÛıÂÓÔ‡˜. AÚ›ÏÈÔ˜ 2010 Afi ÙÔ EıÓÈÎfi T˘ÔÁÚ·-ÊÂ›Ô.http://www.bioethics.gr/media/pdf/opinion_books/informed_consent_opinion_report_gr.pdf (fiˆ˜ ÂÌÊ·Ó›˙ÂÙ·È ÛÙÈ˜29/3/2012).

9. AÛÚ·‰¿ÎË A: H ‚ÈÔËıÈÎ‹ ·Ú¯‹ ÙË˜ ·˘ÙÔÓÔÌ›·˜ ÌÂ ·Ó·ÊÔ-Ú¿ ÛÂ ̇ ËÙ‹Ì·Ù· Ô‰ÔÓÙÈ·ÙÚÈÎ‹˜ ÎÏÈÓÈÎ‹˜ Ú·ÎÙÈÎ‹˜. EÏÏ ™ÙÔÌXÚÔÓ 2009; 53(1): 89-94.

10. http://www.ada.org/prof/prac/law/code/interpretation.htmlPrinciples, Code of Professional Conduct & Advisory Opinionsfiˆ˜ ÂÌÊ·Ó›˙ÂÙ·È ÛÙÈ˜ 11/1/2012.

11. Project of the ABIM Foundation, ACP-ASIM Foundation andEuropean Federation of Internal Medicine: MedicalProfessionalism in the New Millennium: A Physician Charter.Ann Inter Med 2002; 136(3) 243-246.

12. Welie JVM: Is Dentistry a Profession? Part 3. Future Challenges.J Can Dent Assoc 2004; 70(10): 675-678.

13. Reid KI: Respect for patientsã autonomy. JADA 2009; 140:470-474.

14. http://www.eoo.gr/el/nea/diethni-themata/135-seo-kodikas-deontologias-odontiatron-ee (fiˆ˜ ÂÌÊ·Ó›˙ÂÙ·È ÛÙÈ˜28/3/2012).

15. GENERAL DENTAL COUNCIL. STANDARDS GUIDANCE.Principles of patient consent. http://www.gdc-uk.org/Newsandpublications/Publications/Publications/PatientConsent%5B1%5D. (fiˆ˜ ÂÌÊ·Ó›˙ÂÙ·È ÛÙÈ˜ 31/3/2012).

16. http://www.aaos.org/about/papers/advistmt/1017.aspAmerican Academy of orthopaedic Surgeons InformationStatement (fiˆ˜ ÂÌÊ·Ó›˙ÂÙ·È ÛÙÈ˜ 29/12/2011).

17. Kurtz SM: Doctor-Patient Communication: Principles andPractises. Can J Neurol Sci 2002; 29(Suppl.2): S23-S29.

18. The Headache Study Group of the University of WesternOntario: Predictors of outcome in headache patientspresenting to family physicians - a one year prospective study.Headache J 1986; 26: 285-294.

19. Beckman HB, Frankel RM: The effect of physician behaviouron the collection of data. Ann Int Med 1984; 101: 692-696.

20. Marvel MK, Epstein RM, Flowers K, Beckman HB: Solicitingthe patient’s agenda: have we improved? JAMA 1999; 281(3):283-287.

21. Travaline JM, Ruchinskas R, DAlonzo GE: Patient-PhysicianCommunication: Why and How JAOA 2005; 105(1): 13-18.

22. Kidd J, Patel V, Peile E Carter Y: Clinical and communicationskills. Need to be learnt side by side BMJ 2005; 330: 374-375.

23. Theaker ED, Kay EJ, Gill S: Development and preliminaryevaluation of an instrument designed to assess dentalstudents` communication skills. BDJ 2000; 188: 40-44.

24. MÂÚ¿ÎÔ˘ K, ¢¿ÏÏ· A, £ÂÔ‰ˆÚ›‰Ë˜ ¢: I·ÙÚÈÎfi ·fiÚÚËÙÔ. OÈ«Î·Ù¿ Û˘Óı‹ÎË» ·Ú·‚È¿ÛÂÈ˜. AÚ¯ EÏÏ I·ÙÚ 1999; 16(5):504-510.

25. GENERAL DENTAL COUNCIL. STANDARDS GUIDANCE.Principles of patient confidentiality. http://www.gdc-uk.org/Newsandpublications/Publications/Publications/PatientConfidentiality%5B1%5D. (fiˆ˜ ÂÌÊ·Ó›˙ÂÙ·È ÛÙÈ˜31/3/2012).

26. Bayhead Dental Practice Confidentiality Policyhttp://www.islesmiles.co.uk/confidentiality%20policy.htm(fiˆ˜ ÂÌÊ·Ó›˙ÂÙ·È ÛÙÈ˜ 11/3/2012).

27. KÒ‰ÈÎ·˜ È·ÙÚÈÎ‹˜ ‰ÂÔÓÙÔÏÔÁ›·˜ EÊËÌÂÚ›˜ TË˜ K˘‚ÂÚÓ‹ÛÂ-ˆ˜ TË˜ EÏÏËÓÈÎ‹˜ ¢ËÌÔÎÚ·Ù›·˜. TÂ‡¯Ô˜ ¶ÚÒÙÔ, AÚ. º‡Ï-ÏÔ˘ 287, 28 NÔÂÌ‚Ú›Ô˘ 2005.

28. Little JW, Falace DA, Miller CS, Rhodus NL: DentalManagement of the medically compromised patient. 7th ed.St Louis. Mosby. 2007: 807, 854-855.

¢ÈÂ‡ı˘ÓÛË ÁÈ· ÂÈÎÔÈÓˆÓ›·:MÔÁÔÛÈ¿Ó E˘·ÁÁÂÏ›·™ÙÂÚÁÈÔÁÈ¿ÓÓË 45, TK 71305 HÚ¿ÎÏÂÈÔTËÏ¤ÊˆÓ·: 2810 392473 Î·È 2810 392475E-mail: [email protected]

EI™A°ø°HH ̄ ÚfiÓÈ· ÓÂÊÚÈÎ‹ ÓfiÛÔ˜ (XNN) ·ÔÙÂÏÂ› ¤Ó· ·ÁÎfiÛÌÈÔÚfi‚ÏËÌ· ‰ËÌfiÛÈ·˜ ˘ÁÂ›·˜ ÌÂ ÛËÌ·ÓÙÈÎ¤˜ ÂÈÏÔÎ¤˜fiˆ˜ Ë ÓÂÊÚÈÎ‹ ·ÓÂ¿ÚÎÂÈ·, Ù· Î·Ú‰È·ÁÁÂÈ·Î¿ ÓÔÛ‹-Ì·Ù· Î·È Ô ÚfiˆÚÔ˜ ı¿Ó·ÙÔ˜. H Ù·ÍÈÓfiÌËÛË ÙË˜ XNNÎ·Ù¿ ÛÂÈÚ¿ ·˘Í·ÓfiÌÂÓË˜ ‚·Ú‡ÙËÙ·˜ ‚·Û›˙ÂÙ·È ÛÙÈ˜ ÙÈ-

Ì¤˜ ÙÔ˘ Ú˘ıÌÔ‡ ÛÂÈÚ·Ì·ÙÈÎ‹˜ ‰È‹ıËÛË˜ (P™¢) Ô˘ ÂÎ-ÊÚ¿˙ÂÈ ÙÔÓ Ú˘ıÌfi ÚÔ‹˜ ÙˆÓ ̆ ÁÚÒÓ Ô˘ ‰ÈËıÔ‡ÓÙ·È ‰È·-Ì¤ÛÔ˘ ÙˆÓ ÓÂÊÚÒÓ ÛÙË ÌÔÓ¿‰· ÙÔ˘ ¯ÚfiÓÔ˘. ø˜ ¯Úfi-ÓÈ· ÓÂÊÚÈÎ‹ ·ÓÂ¿ÚÎÂÈ· (XNA) ¯·Ú·ÎÙËÚ›˙ÂÙ·È Ë ÚÔÔ-‰Â˘ÙÈÎ‹ Î·È ÌË ·Ó·ÛÙÚ¤„ÈÌË ·ÒÏÂÈ· ÙË˜ ÏÂÈÙÔ˘ÚÁ›·˜ÙˆÓ ÓÂÊÚÒÓˆÓ, ˆ˜ ‰Â XNA ÙÂÏÈÎÔ‡ ÛÙ·‰›Ô˘ fiÙ·ÓP™¢<15ml/min/1,73m3 Ë ÔÔ›· ‰È·ÚÎÂ› ÁÈ· ÙÚÂÈ˜ ‹ Â-ÚÈÛÛfiÙÂÚÔ˘˜ Ì‹ÓÂ˜ (ÛÙ¿‰ÈÔ 5, ¶›Ó. 1)1-3. Y¿Ú¯ÂÈ ·‰˘-Ó·Ì›· ÙˆÓ ÓÂÊÚÒÓ Ó· ·Ô‚¿ÏÏÔ˘Ó Ù· ÙÔÍÈÎ¿ ·Ú¿Áˆ-Á· Ô˘ ‚Ú›ÛÎÔÓÙ·È ÛÙÔ ·›Ì· Î·È ˆ˜ ÂÎ ÙÔ‡ÙÔ˘ ˘¿Ú¯ÂÈ·‰˘Ó·Ì›· ‰È·Ù‹ÚËÛË˜ ÛÂ Ê˘ÛÈÔÏÔÁÈÎ‹ Î·Ù¿ÛÙ·ÛË ÙË˜Û‡ÛÙ·ÛË˜ Î·È ÙÔ˘ fiÁÎÔ˘ ÙˆÓ ˘ÁÚÒÓ ÙÔ˘ ÛÒÌ·ÙÔ˜1,2. OÈ Û˘¯ÓfiÙÂÚÂ˜ Î·Ù·ÛÙ¿ÛÂÈ˜ Ô˘ ÌÔÚÂ› Ó· Ô‰ËÁ‹ÛÔ˘ÓÛÙËÓ Î·Ù·ÛÙÚÔÊ‹ ÙˆÓ ÓÂÊÚÒÓ Â›Ó·È Ô Û·Î¯·ÚÒ‰Ë˜ ‰È·-‚‹ÙË˜, o ÔÔ›Ô˜ Û˘ÓÈÛÙ¿ Û‹ÌÂÚ· ÙËÓ ÈÔ ÎÔÈÓ‹ ·ÈÙ›· ¤Î-ÙˆÛË˜ ÙË˜ ÓÂÊÚÈÎ‹˜ ÏÂÈÙÔ˘ÚÁ›·˜, ÔÈ ÛÂÈÚ·Ì·ÙÔÓÂ-ÊÚ›ÙÈ‰Â˜, Ë ÔÏ˘Î˘ÛÙÈÎ‹ ÓfiÛÔ˜, Ë ˘ÂÏÔÓÂÊÚ›ÙÈ‰·, ·Á-

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XÚfiÓÈ· ÓÂÊÚÈÎ‹ ÓfiÛÔ˜ Î·È ÛÙÔÌ·ÙÈÎ‹ ˘ÁÂ›·AÈÎ·ÙÂÚ›ÓË ¢ËÌËÙÚ›Ô˘1, ºÏÒÚ· ZÂÚ‚Ô‡-B¿Ï‚Ë2

O fiÚÔ˜ ¯ÚfiÓÈ· ÓÂÊÚÈÎ‹ ÓfiÛÔ˜ (XNN) ÂÌÂÚÈÎÏÂ›ÂÈ Ì›· ÔÈÎÈÏ›· ¯ÚÔÓ›ˆÓ ·ı‹ÛÂˆÓ - Î·Ù·ÛÙ¿ÛÂ-ˆÓ Ô˘ ¤¯Ô˘Ó Û·Ó ·ÔÙ¤ÏÂÛÌ· ÙËÓ ¤ÎÙˆÛË ÙË˜ ÓÂÊÚÈÎ‹˜ ÏÂÈÙÔ˘ÚÁ›·˜. H XNN ·ÔÙÂÏÂ› Úfi-‚ÏËÌ· ‰ËÌfiÛÈ·˜ ˘ÁÂ›·˜ Î·È Â¿Ó ·Ú·ÌÂ›ÓÂÈ ·‰È¿ÁÓˆÛÙË ÌÔÚÂ› Ó· Ô‰ËÁ‹ÛÂÈ ÛÂ ¯ÚfiÓÈ· ÓÂÊÚÈÎ‹·ÓÂ¿ÚÎÂÈ·, Î·Ú‰È·ÁÁÂÈ·Î¿ ÓÔÛ‹Ì·Ù· Î·È ÚfiˆÚÔ ı¿Ó·ÙÔ. H ¯ÚfiÓÈ· ÓÂÊÚÈÎ‹ ·ÓÂ¿ÚÎÂÈ· (XNA) ¯·Ú·ÎÙËÚ›˙ÂÙ·È ·fi ÚÔÔ‰Â˘ÙÈÎ‹ Î·È ÌË ·Ó·ÛÙÚ¤„ÈÌË ·Ò-ÏÂÈ· ÙË˜ ÏÂÈÙÔ˘ÚÁ›·˜ ÙˆÓ ÓÂÊÚÒÓˆÓ ÌÂ ·ÔÙ¤ÏÂÛÌ· ÙËÓ ·‰˘Ó·Ì›· ÙˆÓ ÓÂÊÚÒÓ Ó· ·Ô‚¿ÏÏÔ˘Ó Ù·ÙÔÍÈÎ¿ ·Ú¿ÁˆÁ·. ™˘Ó¤ÂÈ· ·˘ÙÔ‡ Â›Ó·È Ë ·‡ÍËÛË ÙˆÓ ÙÔÍÈÎÒÓ ÚÔ˚fiÓÙˆÓ ÙÔ˘ ÌÂÙ·‚ÔÏÈÛÌÔ‡ ÛÙÔ·›Ì· Î·È Ë Û˘ÛÙËÌ·ÙÈÎ‹ Û˘ÛÛÒÚÂ˘Û‹ ÙÔ˘˜ ÛÙÔÓ ÔÚÁ·ÓÈÛÌfi. ™ÎÔfi˜ ÙË˜ ÂÚÁ·Û›·˜ ·˘Ù‹˜ Â›Ó·È Ó··Ó·ÛÎÔ‹ÛÂÈ ÙËÓ ·ÏÏËÏÂ›‰Ú·ÛË ÌÂÙ·Í‡ ÙË˜ ̄ ÚfiÓÈ·˜ ÓÂÊÚÈÎ‹˜ ÓfiÛÔ˘ Î·È ÙË˜ ÛÙÔÌ·ÙÈÎ‹˜ ̆ ÁÂ›·˜Î·ıÒ˜ Î·È Ó· ·ÚÔ˘ÛÈ¿ÛÂÈ Î·ÙÂ˘ı˘ÓÙ‹ÚÈÂ˜ Ô‰ËÁ›Â˜ ÁÈ· ÙË ‰È·¯Â›ÚÈÛË ÙˆÓ ·ÛıÂÓÒÓ ·˘ÙÒÓ. ŸÛÔÓ ·ÊÔÚ¿ ÛÙËÓ Î·Ù¿ÛÙ·ÛË ÙˆÓ ÂÚÈÔ‰ÔÓÙÈÎÒÓ ÈÛÙÒÓ ÔÏÏ¤˜ ¤ÚÂ˘ÓÂ˜ Û˘ÌÊˆÓÔ‡Ó fiÙÈ ÌÂÁ¿ÏÔÔÛÔÛÙfi ÙˆÓ ·ÛıÂÓÒÓ Ô˘ ˘Ô‚¿ÏÏÔÓÙ·È ÛÂ ·ÈÌÔÎ¿ı·ÚÛË ·ÚÔ˘ÛÈ¿˙Ô˘Ó ·˘ÍËÌ¤Ó· Â›Â‰· ÌÈ-ÎÚÔ‚È·Î‹˜ Ï¿Î·˜ Î·È ÙÚ˘Á›·˜ ÛÂ Û¯¤ÛË ÌÂ ˘ÁÈÂ›˜ Ì¿ÚÙ˘ÚÂ˜ ÂÓÒ Ë ‚·Ú‡ÙËÙ· ÙË˜ ÂÚÈÔ‰ÔÓÙÈÎ‹˜ÓfiÛÔ˘ Û¯ÂÙ›˙ÂÙ·È ÌÂ ÙËÓ ËÏÈÎ›·, ÙËÓ ·ÚÔ˘Û›· Û·Î¯·ÚÒ‰Ë ‰È·‚‹ÙË, ÙÔ Î¿ÓÈÛÌ· Î·È ÙË ‰È¿ÚÎÂÈ·Ô˘ Ô ·ÛıÂÓ‹˜ ˘Ô‚¿ÏÏÂÙ·È ÛÂ ·ÈÌÔÎ¿ı·ÚÛË. ™‡ÌÊˆÓ· ÌÂ ÙÂÏÂ˘Ù·›· ÂÚÂ˘ÓËÙÈÎ¿ ‰Â‰ÔÌ¤Ó·, ·-ÛıÂÓÂ›˜ ÌÂ ÂÚÈÔ‰ÔÓÙÈÎ‹ ÓfiÛÔ ÂÌÊ·Ó›˙Ô˘Ó ·˘ÍËÌ¤Ó· Â›Â‰· ‰ÂÈÎÙÒÓ ÊÏÂÁÌÔÓ‹˜ ÛÙÔÓ ÔÚfi ÙÔ˘·›Ì·Ùfi˜ ÙÔ˘˜. E›ÛË˜, ¤¯ÂÈ ·Ú·ÙËÚËıÂ› fiÙÈ fiÛÔ ÌÂÁ·Ï‡ÙÂÚË Â›Ó·È Ë ‚·Ú‡ÙËÙ· ÙË˜ ÂÚÈÔ‰ÔÓÙÈÎ‹˜ÓfiÛÔ˘, ÙfiÛÔ ÌÈÎÚfiÙÂÚË Â›Ó·È Ë ÛÂÈÚ·Ì·ÙÈÎ‹ ‰È‹ıËÛË, ‰ËÏ·‰‹ ÂÈ‰ÂÈÓˆÌ¤ÓË Ë ÓÂÊÚÈÎ‹ ÏÂÈÙÔ˘Ú-Á›· Î·È ¿Ú· ·˘ÍËÌ¤ÓÂ˜ ÔÈ ÂÈÏÔÎ¤˜ ÙË˜ XNA Î·È Ë ıÓËÛÈÌfiÙËÙ· ÙˆÓ ·ÛıÂÓÒÓ. ¶·Ú¿ÏÏËÏ·, ¤¯ÂÈ‚ÚÂıÂ› fiÙÈ ÌÂÙ¿ ·fi Û˘ÛÙËÌ·ÙÈÎ‹-ÂÓÙ·ÙÈÎ‹ ıÂÚ·Â›· ÙË˜ ÂÚÈÔ‰ÔÓÙ›ÙÈ‰·˜ ÌÂÈÒÓÔÓÙ·È ÔÈ ‰Â›ÎÙÂ˜ÊÏÂÁÌÔÓ‹˜ Î·È ‚ÂÏÙÈÒÓÂÙ·È Ë ·ÓÙ·fiÎÚÈÛË ÙˆÓ ·ÛıÂÓÒÓ ÛÙËÓ ·ÈÌÔÎ¿ı·ÚÛË.H ÙÂÚË‰ÔÓÈÎ‹ ÚÔÛ‚ÔÏ‹ ÙˆÓ ÓÂÊÚÔ·ıÒÓ ‰ÂÓ ¤¯ÂÈ ‚ÚÂıÂ› ÛÙ·ÙÈÛÙÈÎ¿ ÛËÌ·ÓÙÈÎ¿ ÌÂÁ·Ï‡ÙÂÚË ·-fi ÙÔÓ ˘ÁÈ‹ ÏËı˘ÛÌfi. ™ÙÔÓ ‚ÏÂÓÓÔÁfiÓÔ ÙÔ˘ ÛÙfiÌ·ÙÔ˜ Û˘¯ÓfiÙÂÚ· Â˘Ú‹Ì·Ù· Â›Ó·È Ù· ·ÈÌ·ÙÒÌ·-Ù· Î·È ÔÈ ÂÎ¯˘ÌÒÛÂÈ˜ ÂÓÒ ÛÙ· ÔÛÙ¿ ÙˆÓ ÁÓ¿ıˆÓ ·Ú·ÙËÚÔ‡ÓÙ·È ÔÛÙÂÔˆÚˆÙÈÎ¤˜ ‚Ï¿‚Â˜.H ·ÓÙÈÌÂÙÒÈÛË ÙˆÓ ·ÛıÂÓÒÓ ·˘ÙÒÓ ÛÙÔ Ô‰ÔÓÙÈ·ÙÚÂ›Ô ¯Ú‹˙ÂÈ È‰È·›ÙÂÚË˜ ÚÔÛÔ¯‹˜ Î˘Ú›ˆ˜ ÏfiÁˆÙË˜ Û˘Ó‡·ÚÍË˜ Î·È ¿ÏÏˆÓ ÚÔ‚ÏËÌ¿ÙˆÓ ÁÂÓÈÎ‹˜ ̆ ÁÂ›·˜, ıÂˆÚÂ›Ù·È ‰Â ÂÈ‚Â‚ÏËÌ¤ÓË Ë Û˘ÓÂÚÁ·-Û›· ÙÔ˘ Ô‰ÔÓÙÈ¿ÙÚÔ˘ ÌÂ ÙÔÓ ıÂÚ¿ÔÓÙ· ÓÂÊÚÔÏfiÁÔ.


§¤ÍÂÈ˜ ÎÏÂÈ‰È¿: ¯ÚfiÓÈ· ÓÂÊÚÈÎ‹ ÓfiÛÔ˜, ¯ÚfiÓÈ· ÓÂÊÚÈÎ‹ ·ÓÂ¿Ú-ÎÂÈ·, ÂÚÈÔ‰ÔÓÙÈÎ‹ ÓfiÛÔ˜, ÙÂÚË‰ÔÓÈÎ‹ ÚÔÛ‚Ô-Ï‹, Ô‰ÔÓÙÈ·ÙÚÈÎ‹ ‰È·¯Â›ÚÈÛË

* O‰ÔÓÙ›·ÙÚÔ˜, ∂ÈÌÂÏ‹ÙÚÈ· ∞’ ∂™À, ¢Ú O‰ÔÓÙÈ·ÙÚÈÎ‹˜** O‰ÔÓÙ›·ÙÚÔ˜, ™˘ÓÙÔÓ›ÛÙÚÈ· ¢ÈÂ˘ı‡ÓÙÚÈ· ∂™À, ¢Ú O‰ÔÓÙÈ·ÙÚÈ-Î‹˜, MPhil Med

ÿ‰Ú˘Ì· ÚÔ¤ÏÂ˘ÛË˜: O‰ÔÓÙÈ·ÙÚÈÎfi ΔÌ‹Ì· - ∂È‰ÈÎ‹ ªÔÓ¿‰· ∞ÌÂ∞ÙÔ˘ °ÂÓÈÎÔ‡ ¡ÔÛÔÎÔÌÂ›Ô˘ ∞ÛÎÏËÈÂ›Ô˘ μÔ‡Ï·˜

H ÂÚÁ·Û›· ·Ó·ÎÔÈÓÒıËÎÂ ˆ˜ ∂ÈÛ‹ÁËÛË ÛÙÔ 31Ô ¶·ÓÂÏÏ‹ÓÈÔO‰ÔÓÙÈ·ÙÚÈÎfi ™˘Ó¤‰ÚÈÔ. £ÂÛÛ·ÏÔÓ›ÎË, 11-13 ¡ÔÂÌ‚Ú›Ô˘ 2011.

35

ÁÂÈ·Î¤˜ ÓfiÛÔÈ Î·È ‰È¿ÊÔÚÂ˜ ¿ÏÏÂ˜ ·ÈÙ›Â˜ fiˆ˜ Ê¿ÚÌ·-Î·, ÔÏ˘Û˘ÛÙËÌ·ÙÈÎ¤˜ ÓfiÛÔÈ Î·È Î˘ÛÙÈÎ¤˜, ·ÁÁÂÈ·Î¤˜Î·È ÎÏËÚÔÓÔÌÈÎ¤˜ ·ı‹ÛÂÈ˜ ÙˆÓ ÓÂÊÚÒÓ2,3.ø˜ ·ÔÙ¤ÏÂÛÌ· ÙË˜ ¤ÎÙˆÛË˜ ÙË˜ ÓÂÊÚÈÎ‹˜ ÏÂÈÙÔ˘Ú-Á›·˜, ·Ú·ÙËÚÂ›Ù·È ·‡ÍËÛË ÙˆÓ ÙÔÍÈÎÒÓ ÚÔ˚fiÓÙˆÓ ÙÔ˘ÌÂÙ·‚ÔÏÈÛÌÔ‡ (.¯. Ô˘Ú›·˜, ÎÚÂ·ÙÈÓ›ÓË˜, Ô˘ÚÈÎÔ‡ ÔÍ¤-Ô˜) Î·È Â›ÛÔ‰fi˜ ÙÔ˘˜ ÛÙËÓ Î˘ÎÏÔÊÔÚ›·. OÈ Ô˘Ú·ÈÌÈÎ¤˜ÙÔÍ›ÓÂ˜ ÔÈ ÔÔ›Â˜ ‰ÂÓ ·Ô‚¿ÏÏÔÓÙ·È Â·ÚÎÒ˜ ‰ËÌÈÔ˘Ú-ÁÔ‡Ó Ô˘Ú·ÈÌÈÎfi ÂÚÈ‚¿ÏÏÔÓ ÙÔ ÔÔ›Ô ÚÔÎ·ÏÂ› ÛÙÔÓ·ÛıÂÓ‹ ·Ó·ÈÌ›·, ‰È·Ù·Ú·¯¤˜ ÙË˜ ıÚ¤„Ë˜, ÓÂÊÚÈÎ‹ ÔÛÙÂ-Ô‰˘ÛÙÚÔÊ›· Î·È Ô˘Ú·ÈÌÈÎ‹ ÓÂ˘ÚÔ¿ıÂÈ·. T· Û˘ÛÙ‹Ì·-Ù· Ù· ÔÔ›· ÚˆÙ·Ú¯ÈÎ¿ ÂËÚÂ¿˙ÔÓÙ·È Â›Ó·È ÙÔ Î·Ú-‰È·ÁÁÂÈ·Îfi, ÙÔ Á·ÛÙÚÂÓÙÂÚÈÎfi, ÙÔ ÓÂ˘ÚÈÎfi, ÙÔ ·ÈÌÔÔÈ-ËÙÈÎfi, ÙÔ ÂÓ‰ÔÎÚÈÓÈÎfi Î·È ÙÔ ·ÓÔÛÔÔÈËÙÈÎfi4. EÈ‰ÈÎfiÙÂÚ· fiÛÔÓ ·ÊÔÚ¿ ÛÙÔ ·ÓÔÛÔÔÈËÙÈÎfi Û‡ÛÙËÌ· ÙÔÔ˘Ú·ÈÌÈÎfi ÂÚÈ‚¿ÏÏÔÓ ‰ËÌÈÔ˘ÚÁÂ› ‰˘ÛÏÂÈÙÔ˘ÚÁ›· ÙfiÛÔÛÙËÓ ¤ÌÊ˘ÙË fiÛÔ Î·È ÙËÓ Â›ÎÙËÙË ·ÓÔÛÔÏÔÁÈÎ‹ ·¿-ÓÙËÛË. E›ÛË˜ Ë Ùˆ¯‹ ÛÂ ÚˆÙÂ˝ÓÂ˜ ‰›·ÈÙ· ÙˆÓ ÓÂ-ÊÚÔ·ıÒÓ ÂËÚÂ¿˙ÂÈ ÙËÓ ÈÎ·ÓfiÙËÙ· ·Ú·ÁˆÁ‹˜ ·ÓÙÈ-ÛˆÌ¿ÙˆÓ. ŒÙÛÈ ÔÈ ·ÛıÂÓÂ›˜ ·ÚÔ˘ÛÈ¿˙Ô˘Ó ·ÓÔÛÔÎ·Ù·-ÛÙÔÏ‹ Î·È ¤¯Ô˘Ó ·˘ÍËÌ¤ÓÔ Î›Ó‰˘ÓÔ ·Ó¿Ù˘ÍË˜ ÏÔÈÌÒ-ÍÂˆÓ Î·È ÊÏÂÁÌÔÓÒÓ5,6. EÓ‰ÂÈÎÙÈÎ¿ ·Ó·Ê¤ÚÂÙ·È fiÙÈ Ë Â›-ÛÔ‰Ô˜ ÌÈÎÚÔ‚›ˆÓ ÛÙÔÓ ÔÚÁ·ÓÈÛÌfi ÌÔÚÂ› ÔÏ‡ Â‡ÎÔÏ·Ó· ÚÔÎ·Ï¤ÛÂÈ ÌÈÎÚÔ‚È·Î‹ ÂÓ‰ÔÎ·Ú‰›ÙÈ‰· ¤ÛÙˆ Î·È ¯ˆ-Ú›˜ Ó· ÚÔ¸¿Ú¯ÂÈ ‚Ï¿‚Ë ÙˆÓ ‚·Ï‚›‰ˆÓ ÙË˜ Î·Ú‰È¿˜.H ıÓËÛÈÌfiÙËÙ· ·fi ÌÈÎÚÔ‚È·Î‹ ÂÓ‰ÔÎ·Ú‰›ÙÈ‰· Â›Ó·È Ô-Ï‡ ˘„ËÏ‹ ÁÈ· ÙÔ˘˜ ·ÛıÂÓÂ›˜ ·˘ÙÔ‡˜ Î·È ·ÁÁ›˙ÂÈ ÙÔ 45%ÙˆÓ ÚÔÛ‚ÏËı¤ÓÙˆÓ3,7.

™Â ‰È¿ÊÔÚÂ˜ ÌÂÏ¤ÙÂ˜ ¤¯ÂÈ ‚ÚÂıÂ› fiÙÈ ÌÂ-Á¿ÏÔ ÔÛÔÛÙfi ÙˆÓ ·ÛıÂÓÒÓ Ô˘ ˘Ô-‚¿ÏÏÔÓÙ·È ÛÂ ·ÈÌÔÎ¿ı·ÚÛË (30-50%) ·-ÚÔ˘ÛÈ¿˙ÂÈ ¯ÚfiÓÈ· ÊÏÂÁÌÔÓÒ‰Ë ·ÓÙ›‰Ú·-ÛË ÌÂ ˘„ËÏ¿ Â›Â‰· ‰ÂÈÎÙÒÓ ÊÏÂÁÌÔ-Ó‹˜ ÛÙÔÓ ÔÚfi fiˆ˜ Â›Ó·È Ë C- ·ÓÙÈ‰ÚÒ-Û· ÚˆÙÂ›ÓË Î·È Ë ÈÓÙÂÚÏÂ˘Î›ÓË 6. OÈ Ï¤-ÔÓ Û˘ÓËıÈÛÌ¤ÓÂ˜ ·ÈÙ›Â˜ ÊÏÂÁÌÔÓ‹˜ ÛÙÔ˘˜·ÈÌÔÎ·ı·ÈÚfiÌÂÓÔ˘˜ Â›Ó·È Ë ˘ÔÎÂ›ÌÂÓËÓfiÛÔ˜, ÔÈ ‰È·Ù·Ú·¯¤˜ ıÚ¤„Ë˜, ÙÔ ÔÍÂÈ-‰ˆÙÈÎfi ÛÙÚÂ˜, Ë Î·Ú‰È·Î‹ ·ÓÂ¿ÚÎÂÈ·,ÁÂÓÂÙÈÎÔ› Î·È ·ÓÔÛÔÏÔÁÈÎÔ› ·Ú¿ÁÔÓÙÂ˜,Ë ‰È·‰ÈÎ·Û›· ÙË˜ ·ÈÌÔÎ¿ı·ÚÛË˜ Î·È Ë ·-ÚÔ˘Û›· ‰È·ÊfiÚˆÓ ÌÈÎÚÔ‚›ˆÓ8,9.OÈ ·ÛıÂÓÂ›˜ ÌÂ ÓÂÊÚÈÎ‹ ·ÓÂ¿ÚÎÂÈ· ÛÂÙÂÏÈÎfi ÛÙ¿‰ÈÔ ·ÚÔ˘ÛÈ¿˙Ô˘Ó ·˘ÍËÌ¤ÓÔÎ›Ó‰˘ÓÔ ÂÌÊ¿ÓÈÛË˜ ÂÈÏÔÎÒÓ ÏfiÁˆ ·ıË-ÚÔÛÎÏËÚˆÙÈÎÒÓ ‚Ï·‚ÒÓ fiˆ˜ Â›Ó·È ÙÔ¤ÌÊÚ·ÁÌ· ÙÔ˘ Ì˘ÔÎ·Ú‰›Ô˘, ÙÔ ·ÁÁÂÈ·ÎfiÂÁÎÂÊ·ÏÈÎfi ÂÂÈÛfi‰ÈÔ Î·È Ô ·ÈÊÓ›‰ÈÔ˜ ı¿-Ó·ÙÔ˜ ÏfiÁˆ Î·Ú‰È·ÎÒÓ ·ÚÚ˘ıÌÈÒÓ3.£ÂÚ·Â›· ÂÎÏÔÁ‹˜ ÁÈ· ÙÔ˘˜ ·ÛıÂÓÂ›˜ ÌÂXNA ÙÂÏÈÎÔ‡ ÛÙ·‰›Ô˘ Â›Ó·È Ë ÂÍˆÓÂÊÚÈ-Î‹ Î¿ı·ÚÛË Ë ÔÔ›· ·ÔÙÂÏÂ› ÌÈ· ÙÂ-¯ÓËÙ‹ Ì¤ıÔ‰Ô ·ÔÌ¿ÎÚ˘ÓÛË˜ ·fi ÙËÓÎ˘ÎÏÔÊÔÚ›· ÙˆÓ ÓÈÙÚˆ‰ÒÓ Î·È ¿ÏÏˆÓ ÙÔ-ÍÈÎÒÓ ÚÔ˚fiÓÙˆÓ ÙÔ˘ ÌÂÙ·‚ÔÏÈÛÌÔ‡. H

ÂÍˆÓÂÊÚÈÎ‹ Î¿ı·ÚÛË ÂÚÈÏ·Ì‚¿ÓÂÈ ‰‡Ô ÙÂ¯ÓÈÎ¤˜: ÙËÓÂÚÈÙÔÓ·˚Î‹ Î¿ı·ÚÛË Î·È ÙËÓ ·ÈÌÔÎ¿ı·ÚÛË ÌÂ ÙÂ¯ÓËÙfiÓÂÊÚfi4.

XNA KAI NO™OI TOY ¶EPIO¢ONTIOY H ·ÌÊ›‰ÚÔÌË Û¯¤ÛË ÌÂÙ·Í‡ ÂÚÈÔ‰ÔÓÙÈÎ‹˜ Î·È Û˘ÛÙË-Ì·ÙÈÎ‹˜ ̆ ÁÂ›·˜ ¤¯ÂÈ ·ÔÙÂÏ¤ÛÂÈ ·ÓÙÈÎÂ›ÌÂÓÔ ¤ÓÙÔÓÔ˘ ÂÚÂ˘-ÓËÙÈÎÔ‡ ÂÓ‰È·Ê¤ÚÔÓÙÔ˜ Ù· ÙÂÏÂ˘Ù·›· ¯ÚfiÓÈ·. H ÂÚÈÔ-‰ÔÓÙÈÎ‹ ÓfiÛÔ˜, ˆ˜ ÁÓˆÛÙfiÓ, ·ÔÙÂÏÂ› ÌÈ· ¯ÚfiÓÈ· ÊÏÂÁ-ÌÔÓÒ‰Ë ÓfiÛÔ ÙˆÓ ÛÙËÚÈÎÙÈÎÒÓ ÈÛÙÒÓ ÙˆÓ ‰ÔÓÙÈÒÓ, Ë ÔÔ›·ÔÊÂ›ÏÂÙ·È ÛÂ ÂÚÈÔ‰ÔÓÙÔ·ıÔÁfiÓÔ˘˜ ÌÈÎÚÔÔÚÁ·ÓÈÛÌÔ‡˜.H ·Î¤Ú·ÈË ¤ÌÊ˘ÙË Î·È Â›ÎÙËÙË ·ÓÔÛ›· Â›Ó·È ··Ú·›ÙËÙËÁÈ· ÙËÓ ‰È·Ù‹ÚËÛË ÙË˜ ÂÚÈÔ‰ÔÓÙÈÎ‹˜ ˘ÁÂ›·˜. A˘Ùfi Î·-Ù·‰ÂÈÎÓ‡ÂÙ·È ·fi ÙÔÓ ·˘ÍËÌ¤ÓÔ ÂÈÔÏ·ÛÌfi ÓfiÛˆÓ ÙÔ˘ÂÚÈÔ‰ÔÓÙ›Ô˘ ÛÂ ¿ÙÔÌ· ÌÂ ÓfiÛÔ˘˜ ÛÙÈ˜ ÔÔ›Â˜ ÂËÚÂ¿-˙ÂÙ·È Ë ·ÓÔÛ›· fiˆ˜ .¯. ÛÙËÓ ¯ÚfiÓÈ· ÎÔÎÎÈˆÌ·ÙÒ‰Ë Ófi-ÛÔ ‹ ÛÙÔ AIDS10,11. ™ÙÔÈ¯Â›· ‰Â›¯ÓÔ˘Ó fiÙÈ Ë ÂÚÈÔ‰ÔÓÙÈÎ‹ÓfiÛÔ˜ ÌÔÚÂ› Ó· ·˘Í‹ÛÂÈ ÙÔÓ Î›Ó‰˘ÓÔ ÂÌÊ¿ÓÈÛË˜ ·ıË-ÚÔÛÎÏ‹ÚˆÛË˜, ÂÌÊÚ¿ÁÌ·ÙÔ˜ ÙÔ˘ Ì˘ÔÎ·Ú‰›Ô˘, ÂÁÎÂÊ·-ÏÈÎÒÓ ÂÂÈÛÔ‰›ˆÓ, Á¤ÓÓËÛË˜ ÚfiˆÚˆÓ Î·È ÌÂÈˆÌ¤ÓÔ˘ ‚¿-ÚÔ˘˜ ÓÂÔÁÓÒÓ, ÓÔÛËÌ¿ÙˆÓ ÙÔ˘ ·Ó·ÓÂ˘ÛÙÈÎÔ‡, ÓfiÛÔ˘Alzheimer Î·È ¿ÏÏˆÓ Û˘ÛÙËÌ·ÙÈÎÒÓ Î·Ù·ÛÙ¿ÛÂˆÓ12-18.

MË¯·ÓÈÛÌÔ› Û‡Ó‰ÂÛË˜ ÙË˜ ÂÚÈÔ‰ÔÓÙÈÎ‹˜ ÓfiÛÔ˘ ÌÂ Ù·ÁÂÓÈÎ¿ ÓÔÛ‹Ì·Ù· OÈ ‚·ÛÈÎÔ› ÌË¯·ÓÈÛÌÔ› Û‡Ó‰ÂÛË˜ ÙË˜ ÂÚÈÔ‰ÔÓÙÈÎ‹˜ Ófi-ÛÔ˘ ÌÂ Ù· ÁÂÓÈÎ¿ ÓÔÛ‹Ì·Ù· Â›Ó·È:1. OÈ ÎÔÈÓÔ› ·Ú¿ÁÔÓÙÂ˜ ÎÈÓ‰‡ÓÔ˘ ÁÈ· ÙËÓ ÂÚÈÔ‰ÔÓÙÈÎ‹

36

∞Ó·ÛÎfiËÛË


¶›Ó·Î·˜ 1

™TA¢IA XPONIA™ NEºPIKH™ NO™OY (XNN)

™Ù¿‰ÈÔ ¶ÂÚÈÁÚ·Ê‹ XNN P™¢* ™¯ÂÙÈÎ‹ ml/min/1,73m3 ÔÚÔÏÔÁ›·

1 NÂÊÚÈÎ‹ ‚Ï¿‚Ë ≥ 90 §Â˘ÎˆÌ·ÙÔ˘Ú›·ÌÂ Ê˘ÛÈÔÏÔÁÈÎfi ‹ ¶ÚˆÙÂÈÓÔ˘Ú›·

˘„ËÏfi P™¢ AÈÌ·ÙÔ˘Ú›·

2 NÂÊÚÈÎ‹ ‚Ï¿‚Ë 60-89 §Â˘ÎˆÌ·ÙÔ˘Ú›·ÌÂ ÂÏ·ÊÚÒ˜ ¶ÚˆÙÂÈÓÔ˘Ú›·¯·ÌËÏfi P™¢ AÈÌ·ÙÔ˘Ú›·

3 M¤ÙÚÈ· ÂÏ¿ÙÙˆÛË 30-59 XÚfiÓÈ·/·Ú¯fiÌÂÓËP™¢ ÓÂÊÚÈÎ‹ ·ÓÂ¿ÚÎÂÈ·

4 ™Ô‚·Ú‹ ÂÏ¿ÙÙˆÛË 15-29 XÚfiÓÈ·/ÚÔ¯ˆÚËÌ¤ÓËP™¢ ÓÂÊÚÈÎ‹ ·ÓÂ¿ÚÎÂÈ·

5 XÚfiÓÈ· ÓÂÊÚÈÎ‹ <15 TÂÏÈÎ¿ ÛÙ¿‰È· ·ÓÂ¿ÚÎÂÈ· ÓÂÊÚÈÎ‹˜

ÙÂÏÈÎÔ‡ ÓfiÛÔ˘, ÛÙ·‰›Ô˘ O˘Ú·ÈÌ›·

* P˘ıÌfi˜ ™ÂÈÚ·Ì·ÙÈÎ‹˜ ¢È‹ıËÛË˜

ÓfiÛÔ Î·È Ù· Û˘ÛÙËÌ·ÙÈÎ¿ ÚÔ‚Ï‹Ì·Ù· ̆ ÁÂ›·˜. ø˜ ÎÔÈ-ÓÔ› ·Ú¿ÁÔÓÙÂ˜ ÎÈÓ‰‡ÓÔ˘ ¤¯Ô˘Ó ıÂˆÚËıÂ› ÙÔ Î¿ÓÈ-ÛÌ·, ÙÔ ÛÙÚÂ˜ Î·È Ë ËÏÈÎ›·.

2. H ·ÚÔ˘Û›· ÌÂÁ¿ÏÔ˘ ·ÚÈıÌÔ‡ Gram(-) ÌÈÎÚÔ‚›ˆÓ Ô˘ÌÔÚÂ› Ó· ÚÔÎ·Ï¤ÛÔ˘Ó ÌÈÎÚÔ‚È·ÈÌ›· Î·È ·Ú¿ÏÏËÏ·¤¯ÂÈ ‚ÚÂıÂ› fiÙÈ ·ÚÂÌÔ‰›˙Ô˘Ó ÙËÓ ·Ì˘ÓÙÈÎ‹ ÏÂÈÙÔ˘ÚÁ›·ÙÔ˘ ÔÚÁ·ÓÈÛÌÔ‡ Ì¤Ûˆ ‰È·ÊfiÚˆÓ ÚÔ˚fiÓÙˆÓ ÙÔ˘˜ fiˆ˜Â›Ó·È .¯. Ô ÏÈÔÔÏ˘Û·Î¯·Ú›ÙË˜ ÙÔ˘ Porphyromonasgingivalis.

3. H ·ÚÔ˘Û›· ÙË˜ ÂÚÈÔ‰ÔÓÙÈÎ‹˜ ÓfiÛÔ˘ ·˘Í¿ÓÂÈ ÛË-Ì·ÓÙÈÎ¿ ÙÈ˜ Û˘ÁÎÂÓÙÚÒÛÂÈ˜ ÙˆÓ ÌÂÛÔÏ·‚ËÙÒÓ ÊÏÂÁ-ÌÔÓ‹˜ fiˆ˜ Â›Ó·È Ë ÈÓÙÂÚÏÂ˘Î›ÓË-1 (IL-1), Ë ÈÓÙÂÚ-ÏÂ˘Î›ÓË-6 (IL-6), Ô ·Ú¿ÁÔÓÙ·˜ Ó¤ÎÚˆÛË˜ ÙˆÓ fiÁÎˆÓ-· (TNF-a) Î·ıÒ˜ Î·È Ë C ·ÓÙÈ‰ÚÒÛ· ÚˆÙÂ˝ÓË (CRP).H ‰È¿¯˘ÛË ÙˆÓ Ô˘ÛÈÒÓ ·˘ÙÒÓ ÚÔ˜ ÙË Û˘ÛÙËÌ·ÙÈÎ‹Î˘ÎÏÔÊÔÚ›· ıÂˆÚÂ›Ù·È fiÙÈ ·ÔÙÂÏÂ› ÙÔ Û˘Ó‰ÂÙÈÎfi ÎÚ›-ÎÔ ÌÂÙ·Í‡ ÂÚÈÔ‰ÔÓÙÈÎ‹˜ ÓfiÛÔ˘ Î·È ÁÂÓÈÎÒÓ ÓÔÛË-Ì¿ÙˆÓ18-24.

¶ÂÚÈÔ‰ÔÓÙÈÎ‹ Î·Ù¿ÛÙ·ÛË ·ÛıÂÓÒÓ Ô˘ ˘Ô‚¿ÏÏÔÓÙ·ÈÛÂ ·ÈÌÔÎ¿ı·ÚÛË TÈ˜ ÙÂÏÂ˘Ù·›Â˜ ÙÚÂÈ˜ ‰ÂÎ·ÂÙ›Â˜ ÌÂÏ¤ÙÂ˜ ·fi ‰È¿ÊÔÚ·Ì¤ÚË ÙÔ˘ ÎfiÛÌÔ˘ ¤¯Ô˘Ó ‰Â›ÍÂÈ fiÙÈ ÔÈ ·ÛıÂÓÂ›˜ Ô˘ ̆ Ô-‚¿ÏÏÔÓÙ·È ÛÂ ·ÈÌÔÎ¿ı·ÚÛË ÂÌÊ·Ó›˙Ô˘Ó ·˘ÍËÌ¤Ó· Â›-Â‰· Ô‰ÔÓÙÈÎ‹˜ ÌÈÎÚÔ‚È·Î‹˜ Ï¿Î·˜, ÛÂ Û¯¤ÛË ÌÂ ˘ÁÈ-Â›˜ Ì¿ÚÙ˘ÚÂ˜. OÈ ÂÚÈÛÛfiÙÂÚÂ˜ ÌÂÏ¤ÙÂ˜ ¤¯Ô˘Ó ‰Â›ÍÂÈfiÙÈ Ë Ô˘Ï›ÙÈ‰· Î·È Ë ÂÚÈÔ‰ÔÓÙ›ÙÈ‰· Â›Ó·È Û˘¯Ófi Â‡ÚË-Ì· ÛÙÔ˘˜ ·ÈÌÔÎ·ı·ÈÚfiÌÂÓÔ˘˜ ·ÛıÂÓÂ›˜. H ÔÛfiÙËÙ·ÙË˜ ÌÈÎÚÔ‚È·Î‹˜ Ï¿Î·˜ Î·È Ë ‚·Ú‡ÙËÙ· ÙË˜ ÊÏÂÁÌÔ-Ó‹˜ ÙˆÓ Ô‡ÏˆÓ Û¯ÂÙ›˙ÔÓÙ·È ÌÂ ÙËÓ ËÏÈÎ›· ÙÔ˘ ·ÛıÂÓ‹,ÙËÓ ·ÚÔ˘Û›· Û·Î¯·ÚÒ‰Ë ‰È·‚‹ÙË, ÙÔ Î¿ÓÈÛÌ· Î·È ÌÂÙË ‰È¿ÚÎÂÈ· ÛÂ ¤ÙË Ô˘ Ô ·ÛıÂÓ‹˜ ˘Ô‚¿ÏÏÂÙ·È ÛÂ ·È-ÌÔÎ¿ı·ÚÛË25-28. ŸÛÔÓ ·ÊÔÚ¿ ÛÙËÓ ·ÚÔ˘Û›· ÙÚ˘Á›·˜ Ë ÏÂÈÔÓfiÙËÙ· ÙˆÓÌÂÏÂÙÒÓ ‰Â›¯ÓÂÈ fiÙÈ ÔÈ ·ÈÌÔÎ·ı·ÈÚfiÌÂÓÔÈ ·ÚÔ˘ÛÈ¿˙Ô˘ÓÌÂÁ·Ï‡ÙÂÚË ÂÓ·fiıÂÛË ÙÚ˘Á›·˜ ÛÂ Û‡ÁÎÚÈÛË ÌÂ ÙÔ˘˜˘ÁÈÂ›˜ ÛÂ ‚·ıÌfi ÛÙ·ÙÈÛÙÈÎ¿ ÛËÌ·ÓÙÈÎfi. M›· Èı·Ó‹ ÂÍ‹-ÁËÛË ÙÔ˘ Ê·ÈÓÔÌ¤ÓÔ˘ ·˘ÙÔ‡ Â›Ó·È fiÙÈ ·Ó Î·È ÔÈ ·ÛıÂÓÂ›˜·ÚÔ˘ÛÈ¿˙Ô˘Ó ÁÂÓÈÎ¿ ÌÂÙ·‚ÔÏÈÎ‹ ÔÍ¤ˆÛË, Ùo pH ÙÔ˘Û¿ÏÈÔ˘ Â›Ó·È Û˘Ó‹ıˆ˜ ·ÏÎ·ÏÈÎfi ·fi ÙËÓ ·˘ÍËÌ¤ÓË ·-ÚÔ˘Û›· ÓÈÙÚˆ‰ÒÓ ÚÔ˚fiÓÙˆÓ fiˆ˜ Ë Ô˘Ú›·, ÁÂÁÔÓfi˜ Ô˘ÂÓÈÛ¯‡ÂÈ ÙËÓ ÂÓ·fiıÂÛË ·Ï¿ÙˆÓ ÛÙËÓ Ô‰ÔÓÙÈÎ‹ ÌÈÎÚÔ-‚È·Î‹ Ï¿Î·29-33.

™˘Û¯¤ÙÈÛË ÙË˜ ÂÚÈÔ‰ÔÓÙÈÎ‹˜ ÓfiÛÔ˘ ÌÂ ÙË XNAŸˆ˜ ÚÔ·Ó·Ê¤ÚıËÎÂ, Ë ·ÚÔ˘Û›· ÌfiÏ˘ÓÛË˜ Î·È ÊÏÂÁ-ÌÔÓ‹˜ ¤¯ÂÈ ÚÔÙ·ıÂ› ˆ˜ ¤Ó·˜ ‚ÈÔÏÔÁÈÎ¿ Â‡ÏÔÁÔ˜ ÌË¯·-ÓÈÛÌfi˜ Ô˘ Û˘Ó‰¤ÂÈ ÙËÓ ·ÚÔ˘Û›· ÂÚÈÔ‰ÔÓÙÈÎ‹˜ ÓfiÛÔ˘ÌÂ ¿ÏÏ· Û˘ÛÙËÌ·ÙÈÎ¿ ÓÔÛ‹Ì·Ù·. ™Ù· Ï·›ÛÈ· ·˘Ù¿, Ë‡·ÚÍË Û˘Û¯¤ÙÈÛË˜ ÌÂÙ·Í‡ ÂÚÈÔ‰ÔÓÙÈÎ‹˜ ÓfiÛÔ˘ Î·È ÓÂ-ÊÚÈÎ‹˜ ÏÂÈÙÔ˘ÚÁ›·˜ ¤¯ÂÈ ·ÔÙÂÏ¤ÛÂÈ ·ÓÙÈÎÂ›ÌÂÓÔ ÂÚÂ˘-ÓËÙÈÎÔ‡ ÂÓ‰È·Ê¤ÚÔÓÙÔ˜.¶ÚÒÙÔÈ ÔÈ Rahmati Î·È Û˘Ó. ÙÔ 2002 ‰ÈÂÚÂ‡ÓËÛ·Ó ÙÔ Î·-Ù¿ fiÛÔ Ë ·ÚÔ˘Û›· ÂÚÈÔ‰ÔÓÙÈÎ‹˜ ÓfiÛÔ˘ ÌÔÚÂ› Ó·Û˘Ì‚¿ÏÏÂÈ ÛÙ· ·˘ÍËÌ¤Ó· Â›Â‰· ÙË˜ CRP ÛÂ ·ÛıÂÓÂ›˜

Ô˘ ˘Ô‚¿ÏÏÔÓÙ·È ÛÂ ·ÈÌÔÎ¿ı·ÚÛË. °È· ÙÔ ÛÎÔfi ·˘ÙfiÛ˘ÌÂÚÈ¤Ï·‚·Ó ÛÙËÓ ÌÂÏ¤ÙË ÙÔ˘˜ 86 ÂÓfi‰ÔÓÙÂ˜ ·ÈÌÔ-Î·ı·ÈÚfiÌÂÓÔ˘˜ ·ÛıÂÓÂ›˜. ™Ù· ¿ÙÔÌ· ·˘Ù¿ ˘ÔÏÔÁ›ÛÙË-Î·Ó Ù· Â›Â‰· ÙË˜ ·ÓÔÛÔÛÊ·ÈÚ›ÓË˜ G (IgG) ÙÔ˘ ÔÚÔ‡¤Ó·ÓÙÈ ¤ÍÈ ÂÚÈÔ‰ÔÓÙÔ·ıÔÁfiÓˆÓ ÌÈÎÚÔ‚›ˆÓ, ÚÔÎÂÈÌ¤-ÓÔ˘ Ó· Á›ÓÂÈ ‰È¿ÁÓˆÛË ÙË˜ ÂÚÈÔ‰ÔÓÙÈÎ‹˜ ÓfiÛÔ˘, Î·ıÒ˜Î·È ÙˆÓ ÂÈ¤‰ˆÓ ÙË˜ CRP. OÈ ÂÚÂ˘ÓËÙ¤˜ Î·Ù¤ÏËÍ·Ó ÛÙË‰È·›ÛÙˆÛË fiÙÈ Ë ·ÚÔ˘Û›· ÂÚÈÔ‰ÔÓÙÈÎ‹˜ ÓfiÛÔ˘, fiˆ˜·˘Ù‹ ÚÔÎ‡ÙÂÈ ·fi Ù· ·˘ÍËÌ¤Ó· Â›Â‰· ÙË˜ (IgG) ÙÔ˘ÔÚÔ‡ ¤Ó·ÓÙÈ ÂÚÈÔ‰ÔÓÙÔ·ıÔÁfiÓˆÓ ÌÈÎÚÔ‚›ˆÓ, Û˘Û¯Â-Ù›˙ÂÙ·È ÌÂ ÙËÓ ÂÌÊ¿ÓÈÛË ̆ „ËÏÒÓ ÂÈ¤‰ˆÓ CRP ÛÙÔÓ ÔÚfi·ÙfiÌˆÓ Ô˘ ˘Ô‚¿ÏÏÔÓÙ·È ÛÂ ·ÈÌÔÎ¿ı·ÚÛË34.™Â ÌÈ· ¿ÏÏË, ÈÔ ÚfiÛÊ·ÙË ÌÂÏ¤ÙË ÙˆÓ Kshirsagar Î·ÈÛ˘Ó. ‰È·ÈÛÙÒıËÎÂ ‡·ÚÍË ÛÙ·ÙÈÛÙÈÎ¿ ÛËÌ·ÓÙÈÎ‹˜ Û˘-Û¯¤ÙÈÛË˜ ÌÂÙ·Í‡ ÌÂÈˆÌ¤ÓË˜ ÓÂÊÚÈÎ‹˜ ÏÂÈÙÔ˘ÚÁ›·˜ Î·È˘„ËÏÒÓ Ù›ÙÏˆÓ ·ÓÙÈÛˆÌ¿ÙˆÓ ¤Ó·ÓÙÈ Û˘ÁÎÂÎÚÈÌ¤ÓˆÓ Â-ÚÈÔ‰ÔÓÙÔ·ıÔÁfiÓˆÓ ÌÈÎÚÔ‚›ˆÓ35. OÈ Kshirsagar Î·È Û˘Ó. ÙÔ 2005 ÛÂ Û˘Á¯ÚÔÓÈÎ‹ ÌÂÏ¤ÙËÛÂ ÌÂÁ¿ÏÔ ‰Â›ÁÌ· (5537) ·ÙfiÌˆÓ Ì¤ÛË˜ ËÏÈÎ›·˜ Î·Ù¤-ÏËÍ·Ó ÛÙË ‰È·›ÛÙˆÛË fiÙÈ Ë ·ÚÔ˘Û›· ÂÚÈÔ‰ÔÓÙ›ÙÈ‰·˜Û˘Û¯ÂÙÈ˙fiÙ·Ó ÛÂ ÛÙ·ÙÈÛÙÈÎ¿ ÛËÌ·ÓÙÈÎfi ‚·ıÌfi ÌÂ ¯·ÌË-Ï‹ ÛÂÈÚ·Ì·ÙÈÎ‹ ‰È‹ıËÛË (P™¢ < 60ml/min/1,73m3) Î·È·˘ÍËÌ¤Ó· Â›Â‰· ÎÚÂ·ÙÈÓ›ÓË˜, fiÛÔ ‰Â ÌÂÁ·Ï‡ÙÂÚË ‹Ù·ÓË ‚·Ú‡ÙËÙ· ÙË˜ ÂÚÈÔ‰ÔÓÙÈÎ‹˜ ÓfiÛÔ˘ ÙfiÛÔ ÌÈÎÚfiÙÂÚË‹Ù·Ó Ë ÛÂÈÚ·Ì·ÙÈÎ‹ ‰È‹ıËÛË36.AÓÙ›ÛÙÔÈ¯·, Ë ÌÂÏ¤ÙË ÙˆÓ Fisher Î·È Û˘Ó. Ë ÔÔ›· ÂÚÈÂ-Ï¿Ì‚·ÓÂ Î·È Óˆ‰Ô‡˜ ·ÛıÂÓÂ›˜ Î·Ù·Ï‹ÁÂÈ ÛÙÔ Û˘Ì¤Ú·-ÛÌ· fiÙÈ Ë ·ÓÔ‰ÔÓÙ›·, ˆ˜ ¤Ó‰ÂÈÍË ÚÔËÁÔ‡ÌÂÓË˜ ·-ÚÔ˘Û›·˜ ÂÚÈÔ‰ÔÓÙÈÎ‹˜ ÓfiÛÔ˘, ÛÂ ÂÓ‹ÏÈÎÂ˜ >55 ÂÙÒÓÂÌÊ¿ÓÈ˙Â ÛÙ·ÙÈÛÙÈÎ¿ ÛËÌ·ÓÙÈÎ‹ Û˘Û¯¤ÙÈÛË ÌÂ ÙË XNA12.EÈÏ¤ÔÓ, ÔÈ Chen Î·È Û˘Ó. ‰È·›ÛÙˆÛ·Ó fiÙÈ Ë ·ÚÔ˘Û›·‰È·Ù·Ú·¯ÒÓ ıÚ¤„Ë˜ Î·È ÊÏÂÁÌÔÓ‹˜ ÛÂ ·ÛıÂÓÂ›˜ Ô˘˘Ô‚¿ÏÏÔÓÙ·Ó ÛÂ ·ÈÌÔÎ¿ı·ÚÛË ‹Ù·Ó ÈÔ Û˘¯Ó‹ ÛÙ· ¿ÙÔ-Ì· Ô˘ ·ÚÔ˘Û›·˙·Ó ÚÔ¯ˆÚËÌ¤ÓË ÂÚÈÔ‰ÔÓÙ›ÙÈ‰·37. OÈ‰Â Kshirsagar Î·È Û˘Ó. ‚Ú‹Î·Ó fiÙÈ ÔÈ ·ÈÌÔÎ·ı·ÈÚfiÌÂÓÔÈ·ÛıÂÓÂ›˜ Ô˘ ÂÌÊ¿ÓÈ˙·Ó ÚÔ¯ˆÚËÌ¤ÓË ÂÚÈÔ‰ÔÓÙ›ÙÈ‰·Â›¯·Ó ÙÚÂÈ˜ ÊÔÚ¤˜ ÂÚÈÛÛfiÙÂÚÂ˜ Èı·ÓfiÙËÙÂ˜ Ó· ÂÌÊ·-Ó›ÛÔ˘Ó ̄ ·ÌËÏ¿ Â›Â‰· ·Ï‚Ô˘Ì›ÓË˜ ÛÙÔÓ ÔÚfi, Ô˘ ·Ô-ÙÂÏÂ› ÛËÌÂ›Ô Î·Î‹˜ ıÚ¤„Ë˜ Î·È ·˘ÍËÌ¤ÓË˜ ıÓËÛÈÌfiÙË-Ù·˜, ·fi fi,ÙÈ Ù· ¿ÙÔÌ· ÌÂ ËÈfiÙÂÚÂ˜ ÌÔÚÊ¤˜ ÙË˜ ÂÚÈÔ-‰ÔÓÙÈÎ‹˜ ÓfiÛÔ˘, ·ÎfiÌ· Î·È ÌÂÙ¿ ÙËÓ ÂÍ¿ÏÂÈ„Ë ¿ÏÏˆÓ ·-Ú·ÁfiÓÙˆÓ ÎÈÓ‰‡ÓÔ˘ .¯. Î¿ÓÈÛÌ·, ˘¤ÚÙ·ÛË, Û·Î¯·-ÚÒ‰Ë˜ ‰È·‚‹ÙË˜, ËÏÈÎ›·, Ê‡ÏÔ38. OÈ ÌÂÏ¤ÙÂ˜ Ô˘ ‰ÈÂÚÂ˘ÓÔ‡Ó ÙËÓ Èı·Ó‹ Û˘Û¯¤ÙÈÛË ÙË˜ÂÚÈÔ‰ÔÓÙÈÎ‹˜ ÓfiÛÔ˘ ÌÂ ÙÈ˜ ÂÈÏÔÎ¤˜ ÙË˜ XNA Î·È ÙËıÓËÛÈÌfiÙËÙ· ÙˆÓ ·ÈÌÔÎ·ı·ÈÚfiÌÂÓˆÓ ‰È·ÈÛÙÒÓÔ˘Ó fiÙÈ ËıÓËÛÈÌfiÙËÙ· ·fi Î·Ú‰È·ÁÁÂÈ·Î¿ ÓÔÛ‹Ì·Ù· ÛÙÔ˘˜ ·ÈÌÔ-Î·ı·ÈÚfiÌÂÓÔ˘˜ Ô˘ ÂÌÊ·Ó›˙Ô˘Ó Ì¤ÛË˜ ‹ ÚÔ¯ˆÚËÌ¤-ÓË˜ ‚·Ú‡ÙËÙ·˜ ÂÚÈÔ‰ÔÓÙÈÎ‹ ÓfiÛÔ Â›Ó·È ÔÏ‡ ÌÂÁ·Ï‡-ÙÂÚË (¤ˆ˜ Î·È ¤ÓÙÂ ÊÔÚ¤˜) ·fi fi,ÙÈ ÛÙÔ˘˜ ·ÈÌÔÎ·ı·È-ÚfiÌÂÓÔ˘˜ Ô˘ ‰ÂÓ ¿Û¯Ô˘Ó ·fi ÂÚÈÔ‰ÔÓÙÈÎ‹ ÓfiÛÔ ‹ÂÌÊ·Ó›˙Ô˘Ó ·Ú¯fiÌÂÓË ÂÚÈÔ‰ÔÓÙ›ÙÈ‰·. H Û˘Û¯¤ÙÈÛË ·˘-Ù‹ ·Ú·Ì¤ÓÂÈ ÛËÌ·ÓÙÈÎ‹ ·ÎfiÌ· Î·È ÌÂÙ¿ ·fi ÂÍ¿ÏÂÈ„ËÙˆÓ Èı·ÓÒÓ ·ÈÙÈÔÏÔÁÈÎÒÓ ·Ú·ÁfiÓÙˆÓ fiˆ˜ Ë ËÏÈÎ›·,ÙÔ Ê‡ÏÔ Î·È ÙÔ Î¿ÓÈÛÌ·39,40.

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E›‰Ú·ÛË ÙË˜ ÂÚÈÔ‰ÔÓÙÈÎ‹˜ ıÂÚ·Â›·˜ ÛÂ ‰Â›ÎÙÂ˜Û˘ÛÙËÌ·ÙÈÎ‹˜ ÊÏÂÁÌÔÓ‹˜ Ÿˆ˜ ÚÔ·Ó·Ê¤ÚıËÎÂ, ÔÏÏ¤˜ ÂÚÂ˘ÓËÙÈÎ¤˜ ÌÂÏ¤ÙÂ˜ Û˘Ì-ÊˆÓÔ‡Ó ÛÙËÓ ‡·ÚÍË ıÂÙÈÎ‹˜ Û˘Û¯¤ÙÈÛË˜ ÌÂÙ·Í‡ Â-ÚÈÔ‰ÔÓÙÈÎ‹˜ ÓfiÛÔ˘ Î·È Û˘ÛÙËÌ·ÙÈÎ‹˜ ÊÏÂÁÌÔÓ‹˜13-17. EÈ-Ï¤ÔÓ, ÛËÌ·ÓÙÈÎ‹ ÌÂ›ˆÛË ÙË˜ CRP ¤¯ÂÈ ·Ú·ÙËÚËıÂ› ÛÂÌÂÏ¤ÙÂ˜ ·Ú¤Ì‚·ÛË˜ ÌÂÙ¿ ·fi ÌË ¯ÂÈÚÔ˘ÚÁÈÎ‹ ÂÚÈÔ-‰ÔÓÙÈÎ‹ ıÂÚ·Â›· ÙfiÛÔ ÛÂ Û˘ÛÙËÌ·ÙÈÎ¿ ˘ÁÈÂ›˜ fiÛÔ Î·ÈÛÂ ·ÛıÂÓÂ›˜ ÌÂ Û˘ÛÙËÌ·ÙÈÎ¿ ÓÔÛ‹Ì·Ù· Ô˘ ¯·Ú·ÎÙËÚ›-˙ÔÓÙ·È ·fi Î¿ÔÈÔ˘ ‚·ıÌÔ‡ ÊÏÂÁÌÔÓ‹ fiˆ˜ Â›Ó·È Ù· Î·Ú-‰È·ÁÁÂÈ·Î¿ ÓÔÛ‹Ì·Ù· Î·È Ô Û·Î¯·ÚÒ‰Ë˜ ‰È·‚‹ÙË˜22,41,42. T· ÚÔËÁÔ‡ÌÂÓ· Â˘Ú‹Ì·Ù· Ô‰‹ÁËÛ·Ó ÛÙËÓ Ú·ÁÌ·ÙÔ-Ô›ËÛË ÌÈ·˜ ÛÂÈÚ¿˜ ÌÂÏÂÙÒÓ ÔÈ ÔÔ›Â˜ ̂ ˜ ÛÎÔfi Â›¯·Ó ÙË‰ÈÂÚÂ‡ÓËÛË ÙÔ˘ Î·Ù¿ fiÛÔ Ë ÂÚÈÔ‰ÔÓÙÈÎ‹ ıÂÚ·Â›· Â›-Ó·È ‰˘Ó·Ùfi Ó· Ô‰ËÁ‹ÛÂÈ ÛÙË ÌÂ›ˆÛË ÙˆÓ ‰ÂÈÎÙÒÓ ÊÏÂÁ-ÌÔÓ‹˜. ÕÍÈÂ˜ ÌÓÂ›·˜ Â›Ó·È ‰‡Ô ÚfiÛÊ·ÙÂ˜ ·Ó·ÛÎÔ‹ÛÂÈ˜ Ô˘¤¯Ô˘Ó Á›ÓÂÈ ÌÂ ÌÂÙ·-·Ó¿Ï˘ÛË ÌÂÁ¿ÏÔ˘ ·ÚÈıÌÔ‡ ÂÈÏÂÁ-Ì¤ÓˆÓ ÌÂÏÂÙÒÓ Û¯ÂÙÈÎ¿ ÌÂ ÙËÓ Â›‰Ú·ÛË ÙË˜ ÌË ¯ÂÈ-ÚÔ˘ÚÁÈÎ‹˜ ÂÚÈÔ‰ÔÓÙÈÎ‹˜ ıÂÚ·Â›·˜ ÛÙÔ˘˜ ‰Â›ÎÙÂ˜ Û˘-ÛÙËÌ·ÙÈÎ‹˜ ÊÏÂÁÌÔÓ‹˜ ÛÂ ¿ÙÔÌ· ̄ ˆÚ›˜ Û˘ÛÙËÌ·ÙÈÎfi Ófi-ÛËÌ·. H ÌÂÙ·-·Ó¿Ï˘ÛË ÙˆÓ Ioannidou Î·È Û˘Ó. Î·Ù·Ï‹-ÁÂÈ ÛÙË ‰È·›ÛÙˆÛË fiÙÈ Ë ÌË ¯ÂÈÚÔ˘ÚÁÈÎ‹ ÂÚÈÔ‰ÔÓÙÈÎ‹ıÂÚ·Â›· Ô‰ËÁÂ› ÛÂ ÌÂ›ˆÛË ÙˆÓ ÂÈ¤‰ˆÓ ÙË˜ CRP ·Ï-Ï¿ fi¯È ÛÂ ÛÙ·ÙÈÛÙÈÎ¿ ÛËÌ·ÓÙÈÎfi ‚·ıÌfi43, Ë ‰Â ÙˆÓParaskevas Î·È Û˘Ó. ‰È·ÈÛÙÒÓÂÈ ‡·ÚÍË ÌÂÙÚ›Ô˘ ‚·ı-ÌÔ‡ ¤Ó‰ÂÈÍË˜ ÌÂ›ˆÛË˜ ÙˆÓ ÙÈÌÒÓ ÙË˜ CRP ÌÂÙ¿ ·fi Ù¤-ÙÔÈ· ıÂÚ·Â›·22. K·È ÛÙÈ˜ ‰‡Ô ·˘Ù¤˜ ÌÂÙ·-·Ó·Ï‡ÛÂÈ˜,fiÌˆ˜, ‰È·ÈÛÙÒıËÎÂ, ÌÂ›ˆÛË ÙË˜ CRP ÛÂ ÛÙ·ÙÈÛÙÈÎ¿ ÛË-Ì·ÓÙÈÎfi ‚·ıÌfi ÛÙÈ˜ ÌÂÏ¤ÙÂ˜ ÂÎÂ›ÓÂ˜ ÛÙÈ˜ ÔÔ›Â˜ ÁÈÓfiÙ·ÓÂÓÙ·ÙÈÎ‹-Û˘ÛÙËÌ·ÙÈÎ‹ ÂÚÈÔ‰ÔÓÙÈÎ‹ ıÂÚ·Â›· ÌÂ Ù·˘-Ùfi¯ÚÔÓË ÙÔÈÎ‹ ÂÊ·ÚÌÔÁ‹ ‹ Û˘ÛÙËÌ·ÙÈÎ‹ ¯ÔÚ‹ÁËÛË·ÓÙÈ‚›ˆÛË˜. ™Â ËÌÂÙ¤Ú· ¤ÚÂ˘Ó· ÎÏÈÓÈÎ‹˜ ÌÂÏ¤ÙË˜ ·Ú¤Ì‚·ÛË˜ Ô˘Ú·ÁÌ·ÙÔÔÈ‹ıËÎÂ ÛÙÔ °. N. «AÛÎÏËÈÂ›Ô» BÔ‡Ï·˜ ÙÔ2008 ÛÂ ·ÛıÂÓÂ›˜ ˘fi ·ÈÌÔÎ¿ı·ÚÛË ·Ú·Û¯¤ıËÎ·Ó Â›-ÛË˜ ÂÓ‰Â›ÍÂÈ˜ fiÙÈ Ë ÌË ¯ÂÈÚÔ˘ÚÁÈÎ‹ ÂÚÈÔ‰ÔÓÙÈÎ‹ ıÂÚ·-Â›· ÌÔÚÂ› Ó· Û˘Ì‚¿ÏÂÈ ÛÙË ÌÂ›ˆÛË ÙˆÓ Û˘ÁÎÂÓÙÚÒÛÂ-ˆÓ ÙË˜ CRP, ÂÈ‰ÈÎ¿ ÛÂ ·ÛıÂÓÂ›˜ Ô˘ ÂÌÊ·Ó›˙Ô˘Ó ˘„ËÏ¿Â›Â‰· ÙˆÓ ‰ÂÈÎÙÒÓ ÊÏÂÁÌÔÓ‹˜44. T· ·ÔÙÂÏ¤ÛÌ·Ù· ·˘-Ù¿ Û˘ÌÊˆÓÔ‡Ó ÌÂ Ù· Â˘Ú‹Ì·Ù· ÚÔÁÂÓ¤ÛÙÂÚË˜ ÎÏÈÓÈÎ‹˜ÌÂÏ¤ÙË˜ ·Ú¤Ì‚·ÛË˜ ÌÂ ·ÚfiÌÔÈ· ÌÂıÔ‰ÔÏÔÁ›· ÙˆÓKadiroglou Î·È Û˘Ó. fiÔ˘ Â›ÛË˜ ·Ú·ÙËÚ‹ıËÎÂ ÌÂ›ˆÛËÙË˜ CRP Î·È ÙË˜ Ù·¯‡ÙËÙ·˜ Î·ı›˙ËÛË˜ ÂÚ˘ıÚÒÓ Î·ıÒ˜Î·È ·‡ÍËÛË ÙÔ˘ ·ÈÌ·ÙÔÎÚ›ÙË Î·È ÙË˜ ·ÈÌÔÛÊ·ÈÚ›ÓË˜ ÌÂÙ¿·fi ÌË ¯ÂÈÚÔ˘ÚÁÈÎ‹ ÂÚÈÔ‰ÔÓÙÈÎ‹ ıÂÚ·Â›·, ·ÎfiÌË ‰Â‚ÂÏÙ›ˆÛË ÙË˜ ·ÓÙ·fiÎÚÈÛË˜ ÙˆÓ ·ÛıÂÓÒÓ ÛÙËÓ ·ÈÌÔÎ¿-ı·ÚÛË ÌÂ ·ÔÙ¤ÏÂÛÌ· Ó· ÌÂÈˆıÂ› Ë Â‚‰ÔÌ·‰È·›· ··È-ÙÔ‡ÌÂÓË ‰fiÛË ÙË˜ ·ÓıÚÒÈÓË˜ ·Ó·Û˘Ó‰˘·ÛÌ¤ÓË˜ ÂÚ˘-ıÚÔÔÈËÙ›ÓË˜21. ¶¿ÓÙˆ˜, Ú¤ÂÈ Ó· ÂÈÛËÌ¿ÓÔ˘ÌÂ fiÙÈ Ù· ·ÔÙÂÏ¤ÛÌ·Ù·ÙˆÓ ÂÚÂ˘ÓÒÓ Ô˘ Û˘Û¯ÂÙ›˙Ô˘Ó ÙËÓ ÂÚÈÔ‰ÔÓÙÈÎ‹ ÓfiÛÔ ÌÂÙË XNN ‰ÂÓ Â›Ó·È ¿ÓÙÔÙÂ Û˘ÁÎÚ›ÛÈÌ· ÂÍ·ÈÙ›·˜:ñ ÙÔ˘ ‰È·ÊÔÚÂÙÈÎÔ‡ Û¯Â‰È·ÛÌÔ‡ ÙˆÓ ÂÚÂ˘ÓÒÓ,ñ ÙË˜ ÏËıÒÚ·˜ ÙˆÓ ·Ú·ÁfiÓÙˆÓ Ô˘ ÂËÚÂ¿˙Ô˘Ó ÙËÓ

ÁÂÓÈÎ‹ Î·Ù¿ÛÙ·ÛË ÙÔ˘ ·ÛıÂÓ‹ fiˆ˜ .¯. Ô Û·Î¯·ÚÒ-‰Ë˜ ‰È·‚‹ÙË˜ Î·È ÙÔ Î¿ÓÈÛÌ·

ñ ÙˆÓ ‰È·ÊÔÚÂÙÈÎÒÓ ÌÂıfi‰ˆÓ ÂÍ¤Ù·ÛË˜ Î·È ·ÍÈÔÏfiÁË-ÛË˜ ÙË˜ ÂÚÈÔ‰ÔÓÙÈÎ‹˜ Î·Ù¿ÛÙ·ÛË˜ ÙÔ˘ ·ÛıÂÓ‹

ñ Î·È ÙˆÓ ‰È·ÊÔÚÂÙÈÎÒÓ ÌÂıfi‰ˆÓ ·ÍÈÔÏfiÁËÛË˜ ÙË˜ Û˘-ÛÙËÌ·ÙÈÎ‹˜ ÊÏÂÁÌÔÓ‹˜45.

XNA KAI TEPH¢ONIKH ¶PO™BO§HH ‰›·ÈÙ· ÙˆÓ ·ÛıÂÓÒÓ ÌÂ XNN ÂÚÈ¤¯ÂÈ ÔÏÏÔ‡˜ ˘‰·-Ù¿ÓıÚ·ÎÂ˜ Î·È Ï›ÁÂ˜ ÚˆÙÂ˝ÓÂ˜ ÁÈ· Ó· ÂÏ·¯ÈÛÙÔÔÈÔ‡ÓÙ·ÈÙ· ÙÔÍÈÎ¿ ÓÈÙÚÒ‰Ë ÚÔ˚fiÓÙ· Ô˘ ÚÔ¤Ú¯ÔÓÙ·È ·fi ÙÔÓÌÂÙ·‚ÔÏÈÛÌfi ÙˆÓ ÚˆÙÂ˚ÓÒÓ. MÂ ÙËÓ ·˘ÍËÌ¤ÓË Ï‹„Ë ̆ ‰·-Ù·ÓıÚ¿ÎˆÓ ÛÂ Û˘Ó‰˘·ÛÌfi ÌÂ ÙËÓ ·Ú·ÌÂÏËÌ¤ÓË Û˘Ó‹-ıˆ˜ ÛÙÔÌ·ÙÈÎ‹ ˘ÁÈÂÈÓ‹ ÙˆÓ ·ÛıÂÓÒÓ ·˘ÙÒÓ ı· ·Ó·ÌÂÓfi-Ù·Ó ˘„ËÏ‹ ÙÂÚË‰ÔÓÈÎ‹ ÚÔÛ‚ÔÏ‹ ÛÙËÓ ÔÌ¿‰· ·˘Ù‹. ¶·-ÚfiÏ· ·˘Ù¿, ÛÙÈ˜ ÌÂÏ¤ÙÂ˜ Ô˘ ¤¯Ô˘Ó ·Û¯ÔÏËıÂ› ÌÂ ÙËÓ Î·-Ù·ÁÚ·Ê‹ ÙˆÓ ÂÏÏÂÈfiÓÙˆÓ, ÙÂÚË‰ÔÓÈÛÌ¤ÓˆÓ ‹ ÂÌÊÚ·Á-Ì¤ÓˆÓ ‰ÔÓÙÈÒÓ ÙˆÓ ·ÛıÂÓÒÓ ·˘ÙÒÓ ÛÂ Û¯¤ÛË ÌÂ ˘ÁÈÂ›˜Ì¿ÚÙ˘ÚÂ˜, ‰ÂÓ ÚÔÎ‡ÙÂÈ ÛÙ·ÙÈÛÙÈÎ¿ ÛËÌ·ÓÙÈÎ‹ ‰È·ÊÔ-Ú¿. AÚÎÂÙ¤˜ ÂÚÁ·Û›Â˜ Û˘ÌÊˆÓÔ‡Ó ÛÙÔ fiÙÈ ˘¿Ú¯ÂÈ ÌÈ·Ù¿ÛË ÙˆÓ ÓÂÊÚÔ·ıÒÓ Ó· ¤¯Ô˘Ó ÏÈÁfiÙÂÚ· ÙÂÚË‰ÔÓÈÛÌ¤-Ó· ‰fiÓÙÈ·. T· ̆ „ËÏfiÙÂÚ· Â›Â‰· Ô˘Ú›·˜ ÛÙÔ Û¿ÏÈÔ Ô˘ÌÂÙ·‚ÔÏ›˙ÂÙ·È ÛÂ ·ÌÌˆÓ›· Î·È ·˘Í¿ÓÂÈ ÙÔ pH ÙÔ˘ ÛÙfiÌ·-ÙÔ˜ ÌÔÚÂ› Ó· ‰ÈÎ·ÈÔÏÔÁ‹ÛÔ˘Ó ÙËÓ Ù¿ÛË ÁÈ· ¯·ÌËÏfiÙÂ-ÚË ··Û‚ÂÛÙ›ˆÛË ÙˆÓ ‰ÔÓÙÈÒÓ Î·È ¯·ÌËÏfiÙÂÚË ÙÂÚË‰Ô-ÓÈÎ‹ ÚÔÛ‚ÔÏ‹. MÂÁ¿ÏÔ Úfi‚ÏËÌ· ·ÔÙÂÏÂ› Ë ·Ú·Ì¤-ÏËÛË ÙË˜ ÛÙÔÌ·ÙÈÎ‹˜ ̆ ÁÈÂÈÓ‹˜ ÙˆÓ ·ÛıÂÓÒÓ ·˘ÙÒÓ ÏfiÁˆÙË˜ ÛˆÌ·ÙÈÎ‹˜ Î·È „˘¯ÔÏÔÁÈÎ‹˜ ÎfiˆÛË˜ Ô˘ ·Ó·fi-ÊÂ˘ÎÙ· ÚÔÎ·ÏÂ› Ë ¯ÚfiÓÈ· ·ÈÌÔÎ¿ı·ÚÛË46-50.

XNA KAI EK¢H§ø™EI™ ™TON B§ENNO°ONO TOY ™TOMATO™H ˆ¯ÚfiÙËÙ· ÙÔ˘ ÛÙÔÌ·ÙÈÎÔ‡ ‚ÏÂÓÓÔÁfiÓÔ˘ ·ÔÙÂÏÂ› ÙÔÈÔ Û˘ÓËıÈÛÌ¤ÓÔ Â‡ÚËÌ· ÛÙÔ˘˜ ·ÈÌÔÎ·ı·ÈÚfiÌÂÓÔ˘˜·ÛıÂÓÂ›˜ ÏfiÁˆ ÙË˜ Ô˘Ú·ÈÌÈÎ‹˜ ·Ó·ÈÌ›·˜. OÈ ÓÂÊÚÔ·-ıÂ›˜ ÂÌÊ·Ó›˙Ô˘Ó ÙËÓ Ù¿ÛË Ó· ·ÈÌÔÚÚ·ÁÔ‡Ó ÏfiÁˆ ÔÈÔ-ÙÈÎÒÓ Î·È ÔÛÔÙÈÎÒÓ ÌÂÙ·‚ÔÏÒÓ ÛÙ· ·ÈÌÔÂÙ¿ÏÈ· Î·È ÛÂ·Ú¿ÁÔÓÙÂ˜ ÙË˜ ‹ÍË˜. E›ÛË˜ ¤¯Ô˘Ó Â‡ıÚ·˘ÛÙ· ÙÚÈ-¯ÔÂÈ‰‹ Î·È ÛÂ Û˘Ó‰˘·ÛÌfi ÌÂ ÙËÓ ·ÓÙÈËÎÙÈÎ‹ ·ÁˆÁ‹ Ô˘Ï·Ì‚¿ÓÔ˘Ó ÂÌÊ·Ó›˙Ô˘Ó Û˘¯Ó¿ ÂÙ¤¯ÂÈÂ˜, ÂÎ¯˘ÌÒÛÂÈ˜Î·È ·ÈÌ·ÙÒÌ·Ù·. ™Â ÌÂÁ¿ÏÔ ÔÛÔÛÙfi ·ÛıÂÓÒÓ ·Ú·ÙË-ÚÂ›Ù·È ÙÚÈ¯ˆÙ‹ ÁÏÒÛÛ·, ÔÛ¯ÂÔÂÈ‰‹˜ ÁÏÒÛÛ· Î·È Î·ÓÙÈ-ÓÙ›·ÛË51-53.H o˘Ú·ÈÌÈÎ‹ ÛÙÔÌ·Ù›ÙÈ‰· ÂÎ‰ËÏÒÓÂÙ·È fiÙ·Ó Ù· Â›Â‰·ÙË˜ Ô˘Ú›·˜ ̆ ÂÚ‚Ô‡Ó Ù· 300mg/dl. ¶ÈÛÙÂ‡ÂÙ·È fiÙÈ ÔÊÂ›-ÏÂÙ·È ÛÙËÓ ·ÌÌˆÓ›· Ô˘ ÂÏÂ˘ıÂÚÒÓÂÙ·È fiÙ·Ó Ë Ô˘ÚÂ¿-ÛË Ô˘ ·Ú¿ÁÂÙ·È ·fi ÙË ÌÈÎÚÔ‚È·Î‹ ̄ ÏˆÚ›‰· ÙÔ˘ ÛÙfi-Ì·ÙÔ˜ ‰È·Û¿ ÙËÓ Ô˘Ú›· ÙÔ˘ Û¿ÏÈÔ˘ Ë ÔÔ›· Â›Ó·È ·˘-ÍËÌ¤ÓË ÛÙÔ˘˜ ·ÛıÂÓÂ›˜ ·˘ÙÔ‡˜. KÏÈÓÈÎ¿ Ë ÓfiÛÔ˜ ÂÌÊ·-Ó›˙ÂÙ·È ÌÂ ‰‡Ô ÌÔÚÊ¤˜: ÙËÓ ÂÏÎˆÙÈÎ‹ Î·È ÙËÓ ÌË ÂÏÎˆÙÈ-Î‹. ™‹ÌÂÚ· ÂÌÊ·Ó›˙ÂÙ·È ÔÏ‡ Û¿ÓÈ·54.OÈ ·ÛıÂÓÂ›˜ ·Ú·ÔÓÔ‡ÓÙ·È ÁÈ· ÍËÚÔÛÙÔÌ›·, ‰‡ÛÔÛÌË·Ó·ÓÔ‹ Î·È ·›ÛıËÌ· ÌÂÙ·ÏÏÈÎ‹˜ ÁÂ‡ÛË˜. ŸÏ· ·˘Ù¿ Â›-

38

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Ó·È ·ÔÙ¤ÏÂÛÌ· ÙË˜ ÌÂÈˆÌ¤ÓË˜ ÚfiÛÏË„Ë˜ ̆ ÁÚÒÓ, ·-ÚÂÓÂÚÁÂÈÒÓ ‰È·ÊfiÚˆÓ Ê·ÚÌ¿ÎˆÓ, ÌÂÙ·‚ÔÏÈÎÒÓ ·ÏÏ·-ÁÒÓ Î·È ÌÂÙ·‚ÔÏÒÓ ÛÙËÓ ¤ÎÎÚÈÛË ÙˆÓ ÛÈÂÏÔÁfiÓˆÓ ·‰¤-ÓˆÓ. TÔ Û¿ÏÈÔ ·ÚÔ˘ÛÈ¿˙ÂÈ ˘„ËÏ¤˜ Û˘ÁÎÂÓÙÚÒÛÂÈ˜ Ô˘-Ú›·˜ Ë ÔÔ›· ‰È·Û¿Ù·È ÛÂ ·ÌÌˆÓ›· Î·È ÚÔÛ‰›‰ÂÈ ÙËÓ¯·Ú·ÎÙËÚÈÛÙÈÎ‹ ÔÛÌ‹ Î·È ÁÂ‡ÛË. E›ÛË˜, ·Ú·ÙËÚÔ‡-ÓÙ·È ÈÔ Û˘¯Ó¿ Ï›ıÔÈ ÛÙÔ˘˜ ÛÈÂÏÔÁfiÓÔ˘˜ ·‰¤ÓÂ˜, Î˘Ú›ˆ˜ÛÙÈ˜ ·ÚˆÙ›‰Â˜55. MÂÛÔÎ˘ÙÙ¿ÚÈ· ÂÓ·fiıÂÛË ·Ì˘ÏÔÂÈ‰Ô‡˜ (·Ì˘ÏÔÂ›‰ˆÛË)ÛÙÔ˘˜ ÈÛÙÔ‡˜ ÙÔ˘ ÛÙfiÌ·ÙÔ˜ ¤¯ÂÈ Â›ÛË˜ ·Ú·ÙËÚËıÂ›ÛÙ· ¿ÙÔÌ· Ô˘ ̆ Ô‚¿ÏÏÔÓÙ·È ÛÂ ̄ ÚfiÓÈ· ·ÈÌÔÎ¿ı·ÚÛË56.

XNA KAI EK¢H§ø™EI™ ™TA O™TAH ÌÂÙ·‚ÔÏÈÎ‹ ÓÂÊÚÈÎ‹ ÔÛÙÂÔ‰˘ÛÙÚÔÊ›· Ô˘ ·ÚÔ˘ÛÈ¿˙Â-Ù·È ÛÙ· ¿ÙÔÌ· ÌÂ XNA Â›Ó·È ·ÔÙ¤ÏÂÛÌ· ‰È·Ù·Ú·¯ÒÓ ÛÙÔÌÂÙ·‚ÔÏÈÛÌfi ·Û‚ÂÛÙ›Ô˘, ÊˆÛÊfiÚÔ˘ Î·È ‚ÈÙ·Ì›ÓË˜ D Î·-ıÒ˜ Î·È ·˘ÍËÌ¤ÓË˜ ‰Ú·ÛÙËÚÈfiÙËÙ·˜ ÙÔ˘ ·Ú·ı˘ÚÂÔÂÈ-‰Ô‡˜. T· Â›Â‰· ·Û‚ÂÛÙ›Ô˘ ÙÔ˘ ·›Ì·ÙÔ˜ Â›Ó·È ÌÂÈˆÌ¤Ó·ÌÂ ·ÔÙ¤ÏÂÛÌ· ÙËÓ ·˘ÍËÌ¤ÓË ·Ô‰¤ÛÌÂ˘ÛË ·Û‚ÂÛÙ›Ô˘·fi Ù· ÔÛÙ¿. ŒÙÛÈ Û˘¯Ó¿ ·Ú·ÙËÚÔ‡ÓÙ·È ÔÛÙÂÔˆÚˆÙÈ-Î¤˜ ‚Ï¿‚Â˜ ÛÙ· ÔÛÙ¿ ÙˆÓ ÁÓ¿ıˆÓ. AÎÙÈÓÔÁÚ·ÊÈÎ¿ ·Ú·-ÙËÚÂ›Ù·È ÌÂ›ˆÛË ÙÔ˘ ÛÔÁÁÒ‰Ô˘˜ ÔÛÙÔ‡ Î·È ÂÈÎfiÓ· Û·Ó«ÙÚÈÌÌ¤ÓÔ Á˘·Ï›», ·ÒÏÂÈ· ÙË˜ lamina dura Î·È ·ÎÙÈÓÔ‰È-

·˘Á¿ÛÂÈ˜ Ô˘ ÌÔÈ¿˙Ô˘Ó ÌÂ ÁÈÁ·ÓÙÔÎ˘ÙÙ·-ÚÈÎfi ÎÔÎÎ›ˆÌ·. H ·ÓÔÚ·ÌÈÎ‹ ·ÎÙÈÓÔÁÚ·-Ê›· ÙˆÓ ÁÓ¿ıˆÓ, Ì¿ÏÈÛÙ·, ıÂˆÚÂ›Ù·È ¤Ó··ÍÈfiÈÛÙÔ ÂÚÁ·ÏÂ›Ô ÛÙËÓ ·ÔÎ¿Ï˘„Ë Ù¤-ÙÔÈˆÓ ‚Ï·‚ÒÓ. ¶·Ú·ÙËÚÔ‡ÓÙ·È, Â›ÛË˜,ÂÓ·Û‚ÂÛÙÈÒÛÂÈ˜ ÙˆÓ Ì·Ï·ÎÒÓ ÈÛÙÒÓ, Û˘-¯Ó¿ Ï›ıÔÈ ÛÙÔ˘˜ ÛÈÂÏÔÁfiÓÔ˘˜ ·‰¤ÓÂ˜ Î·-ıÒ˜ Î·È ÂÓ·Û‚ÂÛÙ›ˆÛË ÙÔ˘ ÔÏÊÔ‡.H ·Ò-ÏÂÈ· ÔÛÙÔ‡ ÌÔÚÂ› Ó· ÚÔÎ·Ï¤ÛÂÈ Î·Ù¿Á-Ì·Ù· ÙˆÓ ÁÓ¿ıˆÓ Î·ÙfiÈÓ ‹ÈÔ˘ ÙÚ·˘Ì·-ÙÈÛÌÔ‡ ‹ ·ÎfiÌ· Î·È ·˘ÙfiÌ·Ù·. O Ô‰ÔÓÙ›·-ÙÚÔ˜ Ú¤ÂÈ Ó· Â›Ó·È ‹ÈÔ˜ Î·È ÚÔÛÂÎÙÈ-Îfi˜ Î·Ù¿ ÙÈ˜ Ô‰ÔÓÙÈ·ÙÚÈÎ¤˜ ÂÂÌ‚¿ÛÂÈ˜.E›ÛË˜ ÛÂ ¤ÚÂ˘Ó·, ÌÂ ·ÎÙÈÓÔÏÔÁÈÎfi ¤ÏÂÁ-¯Ô, ÌÂÙ¿ ·fi ÂÍ·ÁˆÁ‹ ‰ÔÓÙÈÔ‡ ·Ú·ÙËÚ‹-ıËÎÂ ÂÓ·fiıÂÛË ÛÎÏËÚˆÙÈÎÔ‡ ÔÛÙÔ‡ ÛÙÔÊ·ÙÓ›Ô Î·È Î·ı˘ÛÙ¤ÚËÛË ÛÙËÓ ÂÔ‡ÏˆÛËÙÔ˘ ÔÛÙÔ‡. H ·ÔÚÚfiÊËÛË ÙÔ˘ ÔÛÙÔ‡ ÌÔ-ÚÂ› Â›ÛË˜ Ó· ÚÔÎ·Ï¤ÛÂÈ ÎÈÓËÙÈÎfiÙËÙ· ÙˆÓ‰ÔÓÙÈÒÓ Î·È ÚÔ‚Ï‹Ì·Ù· ÛÙË Û‡ÁÎÏÂÈÛË.KÈÓËÙÈÎfiÙËÙ· ‰ÔÓÙÈÒÓ Î·È ÌÂÙ·Ó·ÛÙÂ˘Û‹ÙÔ˘˜ ¤¯ÂÈ ·Ú·ÙËÚËıÂ› ÛÂ ¿ÙÔÌ· ÌÂ XNA¯ˆÚ›˜ ¤ÓÙÔÓË ÂÚÈÔ‰ÔÓÙÈÎ‹ ÓfiÛÔ51,57-60.

¢IAXEIPI™H A™£ENøN ME XNN ™TO O¢ONTIATPEIO O Ô‰ÔÓÙ›·ÙÚÔ˜ Ú¤ÂÈ Ó· Û˘Ì‚¿ÏÏÂÈ ÛÙË‰È·ÛÊ¿ÏÈÛË Î·ÏÔ‡ ÂÈ¤‰Ô˘ ÛÙÔÌ·ÙÈÎ‹˜˘ÁÂ›·˜ È‰È·›ÙÂÚ· ÛÂ Ù¤ÙÔÈÔ˘˜ ÂÈ‚·Ú˘Ì¤-ÓÔ˘˜ ·ÛıÂÓÂ›˜. A·Ú·›ÙËÙÔ Â›Ó·È ÙÔ ÚÔ-ÏËÙÈÎfi ÚfiÁÚ·ÌÌ· ÛÙÔÌ·ÙÈÎ‹˜ ̆ ÁÈÂÈÓ‹˜ÚÔÛ·ÚÌÔÛÌ¤ÓÔ ÛÙÈ˜ ·Ó¿ÁÎÂ˜ ÙÔ˘ Î¿ıÂ·ÛıÂÓ‹ ÌÂ ·Ó·Ï˘ÙÈÎ¤˜ Ô‰ËÁ›Â˜ ÁÈ· ÙÔ‚Ô‡ÚÙÛÈÛÌ· ÙˆÓ ‰ÔÓÙÈÒÓ, ÙËÓ ̄ Ú‹ÛË ÛÙÔ-Ì·ÙÈÎÒÓ ‰È·Ï˘Ì¿ÙˆÓ, ÙË Û˘¯ÓfiÙËÙ· Â›-ÛÎÂ„Ë˜ ÛÙÔÓ Ô‰ÔÓÙ›·ÙÚÔ Î.Ï. ™ËÌÂ›· Ô˘ ̄ Ú‹˙Ô˘Ó ÚÔÛÔ¯‹˜ Î·Ù¿ ÙËÓÔ‰ÔÓÙÈ·ÙÚÈÎ‹ ·ÓÙÈÌÂÙÒÈÛË ·ÛıÂÓÒÓ ÌÂXNN Â›Ó·È Ù· ·ÎfiÏÔ˘ı·:- H Ï‹„Ë ÏÂÙÔÌÂÚÔ‡˜ ÈÛÙÔÚÈÎÔ‡ Â›Ó·È·ÔÏ‡Ùˆ˜ ··Ú·›ÙËÙË ÁÈ· ÙËÓ Ô‰ÔÓÙÈ·-ÙÚÈÎ‹ ·ÓÙÈÌÂÙÒÈÛË ÙˆÓ ·ÛıÂÓÒÓ ·˘ÙÒÓ.

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AÓÙÈÌÈÎÚÔ‚È·Î¿ ÛÙ· ÔÔ›· ¶ÂÓÈÎÈÏÏ›ÓË G¯ÚÂÈ¿˙ÂÙ·È ÙÚÔÔÔ›ËÛË AÌÔÍÈÎÈÏÏ›ÓË, ·ÌÈÎÈÏÏ›ÓËÙË˜ ‰fiÛË˜, ÌfiÓÔ Â› KÂÊ·ÏÔı›ÓË, ÎÂÊ·ÏÂÍ›ÓËÚÔ¯ˆÚËÌ¤ÓË˜ ÓÂÊÚÈÎ‹˜ KÂÊ·Ì·Ó‰fiÏË, ÎÂÊÔÍÈÙ›ÓË·ÓÂ¿ÚÎÂÈ·˜ KÂÊÔÙ·Í›ÌË,ÈÂÚ·ÎÈÏÏ›ÓË

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AÓÙÈÌÈÎÚÔ‚È·Î¿ ÙˆÓ ÔÔ›ˆÓ Ë TÂÙÚ·Î˘ÎÏ›ÓÂ˜ (ÂÎÙfi˜ ‰ÔÍ˘Î˘ÎÏ›ÓË˜)¯Ú‹ÛË ·ÓÙÂÓ‰Â›ÎÓ˘Ù·È Â› NÈÙÚÔÊÔ˘Ú·ÓÙÔ˚ÓËÓÂÊÚÈÎ‹˜ ·ÓÂ¿ÚÎÂÈ·˜ KÂÊ·ÏÔÚÈ‰›ÓË

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E›Ó·È ÛËÌ·ÓÙÈÎfi Ó· ÂÚˆÙ¿Ù·È ¿ÓÙ· Ô ·ÛıÂÓ‹˜ Û¯ÂÙÈÎ¿ÌÂ ÙÔ ÙÈ ÙÔÓ Ô‰‹ÁËÛÂ ÛÙË XNN ¤ÙÛÈ ÒÛÙÂ Ó· Ï·Ì‚¿ÓÂÙ·È˘’ fi„ÈÓ Î·È Ë Èı·Ó‹ ̆ ÔÎÂ›ÌÂÓË ÓfiÛÔ˜, ÚÈÓ ‰Â ·fi Î¿-ıÂ Â¤Ì‚·ÛË Ó· Á›ÓÂÙ·È Û˘ÓÂÓÓfiËÛË ÙÔ˘ Ô‰ÔÓÙÈ¿ÙÚÔ˘ÌÂ ÙÔÓ ÓÂÊÚÔÏfiÁÔ Ô ÔÔ›Ô˜ ÁÓˆÚ›˙ÂÈ ÙËÓ ·ÎÚÈ‚‹ Î·Ù¿-ÛÙ·ÛË ÙË˜ ÁÂÓÈÎ‹˜ ˘ÁÂ›·˜ ÙÔ˘ ·ÛıÂÓ‹. - Ÿˆ˜ ÚÔ·Ó·Ê¤ÚıËÎÂ, ÔÈ ·ÛıÂÓÂ›˜ ÌÂ XNN ·ÚÔ˘-ÛÈ¿˙Ô˘Ó ·˘ÍËÌ¤ÓÔ Î›Ó‰˘ÓÔ ·Ó¿Ù˘ÍË˜ ÏÔÈÌÒÍÂˆÓ Î·ÈÊÏÂÁÌÔÓÒÓ ÔÈ ÔÔ›Â˜, Â¿Ó ‰ÂÓ ÂÏÂÁ¯ıÔ‡Ó, ·ÔÙÂÏÔ‡ÓÛ˘¯Ó‹ ·ÈÙ›· ÓÔÛËÚfiÙËÙ·˜ Î·È ıÓËÛÈÌfiÙËÙ·˜ ÛÙÔ˘˜ ·ÛıÂ-ÓÂ›˜ ·˘ÙÔ‡˜. ŒÙÛÈ, ÚÈÓ ·fi Î¿ıÂ ·ÈÌ·ÙËÚ‹ Ô‰ÔÓÙÈ·-ÙÚÈÎ‹ Â¤Ì‚·ÛË, fiˆ˜ ÂÍ·ÁˆÁ‹ ‰ÔÓÙÈÔ‡ ‹ ıÂÚ·Â›· ÙÔ˘ÂÚÈÔ‰ÔÓÙ›Ô˘, ··ÈÙÂ›Ù·È ·ÓÙÈ‚ÈÔÙÈÎ‹ Î¿Ï˘„Ë ÁÈ· ÙËÓÚÔÛÙ·Û›· ÙÔ˘ ·ÛıÂÓ‹ ·fi ÙË ‚·ÎÙËÚÈ·ÈÌ›·. H ÌÂÈˆÌ¤-ÓË ÓÂÊÚÈÎ‹ ÏÂÈÙÔ˘ÚÁ›· ÙˆÓ ·ÙfiÌˆÓ ÌÂ XNN ·˘Í¿ÓÂÈ ÙÔ¯ÚfiÓÔ ËÌÈ˙ˆ‹˜ ÙˆÓ Ê·ÚÌ¿ÎˆÓ ¤ÛÙˆ Î·È ·Ó Ô ÌÂÙ·‚ÔÏÈ-ÛÌfi˜ ÙÔ˘˜ Á›ÓÂÙ·È Î˘Ú›ˆ˜ ÛÙÔ ‹·Ú. ŒÙÛÈ, ÛÂ ·ÚÎÂÙ¤˜ÂÚÈÙÒÛÂÈ˜, ı· Ú¤ÂÈ Ó· ·˘Í¿ÓÔÓÙ·È Ù· ‰È·ÛÙ‹Ì·Ù·ÌÂÙ·Í‡ ÙˆÓ ‰fiÛÂˆÓ. OÈ ‰fiÛÂÈ˜ ÙˆÓ ÛÎÂ˘·ÛÌ¿ÙˆÓ Ú¤-

ÂÈ Ó· Ú˘ıÌ›˙ÔÓÙ·È ¤ÙÛÈ ÒÛÙÂ Ó· ·ÔÊÂ‡ÁÂÙ·È ËÙÔÍÈÎfiÙËÙ· ·ÏÏ¿ Î·È Ó· ÌË Á›ÓÂÙ·È ̆ ÔıÂÚ·Â›·,··ÁÔÚÂ‡ÔÓÙ·È ‰Â Ù· ÓÂÊÚÔÙÔÍÈÎ¿ Ê¿ÚÌ·Î·.EÓ‰ÂÈÎÙÈÎ¿ ·˘Ù¿ ·Ó·Ê¤ÚÔÓÙ·È ÛÙÔ˘˜ ›Ó·ÎÂ˜ 2Î·È 351, 63-66. - ¶ÚÈÓ ·fi Î¿ıÂ ·ÈÌ·ÙËÚ‹ Â¤Ì‚·ÛË Ú¤ÂÈ Ó·Á›ÓÂÙ·È ÔÏ‡ Î·Ï‹ ÛÙÔÌ·ÙÈÎ‹ ˘ÁÈÂÈÓ‹ ÌÂ ¯Ú‹ÛËÛÙÔÌ·ÙÈÎÒÓ ‰È·Ï˘Ì¿ÙˆÓ ÌÂ ·ÓÙÈÌÈÎÚÔ‚È·Î‹ ‰Ú¿-ÛË ¤ÙÛÈ ÒÛÙÂ Ó· ÌÂÈÒÓÂÙ·È ÙÔ ÌÈÎÚÔ‚È·Îfi ÊÔÚÙ›ÔÙË˜ ÛÙÔÌ·ÙÈÎ‹˜ ÎÔÈÏfiÙËÙ·˜. - ™Â ÂÂ›ÁÔÓ Ô‰ÔÓÙÈ·ÙÚÈÎfi Úfi‚ÏËÌ· Â›ÛË˜ ··È-ÙÂ›Ù·È Û˘ÓÂÓÓfiËÛË ÌÂ ÙÔÓ ıÂÚ¿ÔÓÙ· È·ÙÚfi ÚÈÓ·fi ÔÔÈ·‰‹ÔÙÂ Ô‰ÔÓÙÈ·ÙÚÈÎ‹ Â¤Ì‚·ÛË. H ̄ Ô-Ú‹ÁËÛË ÙË˜ Î·Ù¿ÏÏËÏË˜ ·ÓÙÈ‚›ˆÛË˜ ÂÚÈÏ·Ì-‚¿ÓÂÙ·È Î·È ¿ÏÈ ÛÙ· ı¤Ì·Ù· ÙË˜ Û˘ÓÂÓÓfiËÛË˜·˘Ù‹˜. - °ÂÓÈÎ¿ ‰ÂÓ ··ÁÔÚÂ‡ÂÙ·È Ë ̄ Ú‹ÛË ÙÔÈÎÒÓ ·Ó·È-ÛıËÙÈÎÒÓ ÌÂ ·‰ÚÂÓ·Ï›ÓË. K·Ïfi, fiÌˆ˜, Â›Ó·È Ó·Â›Ì·ÛÙÂ ÚÔÛÂÎÙÈÎÔ› Î·È ÊÂÈ‰ˆÏÔ› ÛÙË ̄ Ú‹ÛË ÙË˜·‰ÚÂÓ·Ï›ÓË˜ ‰ÈfiÙÈ ÔÏÏÔ› ·ÛıÂÓÂ›˜ ÌÂ XNN ·-ÚÔ˘ÛÈ¿˙Ô˘Ó Î·È Î·Ú‰ÈÔÏÔÁÈÎ¿ ÚÔ‚Ï‹Ì·Ù·. ŒÙÛÈ,Û˘ÓÈÛÙ¿Ù·È ÌÂ›ˆÛË ÙË˜ ÔÛfiÙËÙ·˜ ÙˆÓ ¯ÚËÛÈ-ÌÔÔÈÔ‡ÌÂÓˆÓ ·ÁÁÂÈÔÛ˘Û·ÛÙÈÎÒÓ È‰È·›ÙÂÚ·fiÙ·Ó Û˘Ó˘¿Ú¯ÂÈ ‰È·ÁÓˆÛÌ¤ÓË Î·Ú‰ÈÔ¿ıÂÈ·.EÈÙÚ¤ÂÙ·È Ó· ¯ÔÚËÁËıÔ‡Ó Ì¤¯ÚÈ Î·È 3 ·ÌÔ‡-ÏÂ˜ ÙÔÈÎÔ‡ ·Ó·ÈÛıËÙÈÎÔ‡ ÌÂ ÂÚÈÂÎÙÈÎfiÙËÙ· ÛÂ·‰ÚÂÓ·Ï›ÓË 1:100.000 ÌÂ ·ÚÁ‹ ÚÔÛÂÎÙÈÎ‹ ¤Á-¯˘ÛË Î·È ·Ó·ÚÚfiÊËÛË ÁÈ· ·ÔÊ˘Á‹ ÂÓ‰ÔÊÏ¤-‚È·˜ ¤Á¯˘ÛË˜. - K·Ïfi Â›Ó·È Ó· ÂÏ¤Á¯ÂÙ·È Ë ·ÚÙËÚÈ·Î‹ ›ÂÛË ÚÈÓÎ·È Î·Ù¿ ÙË ‰È¿ÚÎÂÈ· ÙË˜ Û˘ÓÂ‰Ú›·˜ ‰ÈfiÙÈ Ô ·ÛıÂ-Ó‹˜ ÌÔÚÂ› Ó· ÂÌÊ·Ó›ÛÂÈ ·˘ÍËÌ¤ÓË Û˘ÛÙÔÏÈÎ‹›ÂÛË ·fi ÙÔ ÛÙÚÂ˜ Ô˘ ÚÔÎ·ÏÂ› Ë È‰¤· ÙË˜ Ô‰Ô-ÓÙÔıÂÚ·Â›·˜. - ™Â È‰È·›ÙÂÚ· ·Á¯Ò‰Ë ¿ÙÔÌ· Û˘ÓÈÛÙ¿Ù·È Ë ¯ÔÚ‹-ÁËÛË Î¿ÔÈÔ˘ ·Á¯ÔÏ˘ÙÈÎÔ‡ Ê·ÚÌ·ÎÂ˘ÙÈÎÔ‡ ÛÎÂ˘-

¿ÛÌ·ÙÔ˜ fiˆ˜ Â›Ó·È Ë ‰È·˙Â¿ÌË ‹ Ë ‚ÚˆÌ·˙Â¿ÌË. TË‰ÔÛÔÏÔÁ›· ÙËÓ Î·ıÔÚ›˙ÂÈ Ô ıÂÚ¿ˆÓ È·ÙÚfi˜ Ô˘ ÁÓˆÚ›-˙ÂÈ Î·Ï‡ÙÂÚ· ÙÈ˜ ·Ó¿ÁÎÂ˜ ÙÔ˘ ·ÛıÂÓ‹. EÈÏ¤ÔÓ ÛËÌÂ›· ÚÔÛÔ¯‹˜ ÁÈ· ÙÔ˘˜ ·ÛıÂÓÂ›˜ ˘fi ·È-ÌÔÎ¿ı·ÚÛË Â›Ó·È Ù· ·ÎfiÏÔ˘ı·:- §fiÁˆ ÙÔ˘ fiÙÈ ÔÏÏÔ› ·ÛıÂÓÂ›˜ ·ÚÔ˘ÛÈ¿˙Ô˘Ó Î·È Î·Ú-‰È·ÁÁÂÈ·Î¿ ÚÔ‚Ï‹Ì·Ù·, Ï¤ÔÓ ÙË˜ Ë·Ú›ÓË˜ Ô˘ ¯ÚË-ÛÈÌÔÔÈÂ›Ù·È Î·Ù¿ ÙËÓ ‰È·‰ÈÎ·Û›· ÙË˜ ·ÈÌÔÎ¿ı·ÚÛË˜,ÙÔ˘˜ ¯ÔÚËÁÔ‡ÓÙ·È ÛÎÂ˘¿ÛÌ·Ù· ·ÓÙÈËÎÙÈÎ‹˜ ·ÁˆÁ‹˜·fi ÙÔ ÛÙfiÌ·. ŒÙÛÈ, ÚÈÓ ·fi Î¿ıÂ ·ÈÌ·ÙËÚ‹ Â¤Ì‚·ÛË(ÂÍ·ÁˆÁ‹ ‰ÔÓÙÈÔ‡, ·ÔÙÚ‡ÁˆÛË, ıÂÚ·Â›· ÙÔ˘ ÂÚÈÔ-‰ÔÓÙ›Ô˘) ¯ÚÂÈ¿˙ÂÙ·È ¤ÏÂÁ¯Ô˜ ÙË˜ ËÎÙÈÎfiÙËÙ·˜ ÙÔ˘ ·›-Ì·ÙÔ˜. ¶ÔÏÏ¤˜ ÊÔÚ¤˜ ‰È·ÎfiÙÔÓÙ·È Ù· ·ÓÙÈËÎÙÈÎ¿ Ê¿Ú-Ì·Î· Î·È ̄ ÔÚËÁÂ›Ù·È Ë·Ú›ÓË ̄ ·ÌËÏÔ‡ ÌÔÚÈ·ÎÔ‡ ‚¿ÚÔ˘˜ÁÈ· 4-7 ËÌ¤ÚÂ˜ ÛÂ Û˘ÓÂÓÓfiËÛË ÌÂ ÙÔÓ Î·Ú‰ÈÔÏfiÁÔ. K·Ïfi Â›Ó·È Î¿ıÂ Ô‰ÔÓÙÈ·ÙÚÈÎ‹ Â¤Ì‚·ÛË Ó· Á›ÓÂÙ·È ËÌ¤-Ú· Ô˘ Ô ·ÛıÂÓ‹˜ ‰ÂÓ ˘Ô‚¿ÏÏÂÙ·È ÛÂ ·ÈÌÔÎ¿ı·ÚÛË¤ÙÛÈ ÒÛÙÂ Ó· ¤¯ÂÈ ·Ú¤ÏıÂÈ ·ÚÎÂÙfi˜ ̄ ÚfiÓÔ˜ ·fi ÙËÓ ̄ Ô-Ú‹ÁËÛË ÙË˜ Ë·Ú›ÓË˜, Ô ‰Â ·ÛıÂÓ‹˜ Ó· Â›Ó·È ‹ÚÂÌÔ˜ Î·È

¶›Ó·Î·˜ 3

ME™O¢IA™THMA (™E øPE™) ¢O™EøN ™YNH£ø™ XOPH°OYMENøN A¶O TON O¢ONTIATPO ºAPMAKøN

™E A™£ENEI™ ME XNN (ÌË ÙÂÏÈÎÔ‡ ÛÙ·‰›Ô˘)

º¿ÚÌ·ÎÔ º˘ÛÈÔÏÔÁÈÎ‹ M¤ÙÚÈ· ¶ÚÔ¯ˆÚËÌ¤ÓËÓÂÊÚÈÎ‹ ÓÂÊÚÈÎ‹ ÓÂÊÚÈÎ‹

ÏÂÈÙÔ˘ÚÁ›· ·ÓÂ¿ÚÎÂÈ· ·ÓÂ¿ÚÎÂÈ·

¶·Ú·ÎÂÙ·ÌfiÏË 4 6-8 8-12

AÛÈÚ›ÓË 4 4-6 AÔÊ˘Á‹ ¯ÔÚ‹ÁËÛË˜

I‚Ô˘ÚÔÊ·›ÓË 6 6-12 AÔÊ˘Á‹ ¯ÔÚ‹ÁËÛË˜

TÔÈÎfi º˘ÛÈÔÏÔÁÈÎ‹ º˘ÛÈÔÏÔÁÈÎ‹ º˘ÛÈÔÏÔÁÈÎ‹·Ó·ÈÛıËÙÈÎfi ¢fiÛË ¢fiÛË ¢fiÛË¶.¯ §È‰ÔÎ·˝ÓË

AÌÔÍ˘ÎÈÏÏ›ÓË 8 8-12 12-18

AÌÈÎÈÏÏ›ÓË 6 6-9 9-12

KÂÊ·ÏÂÍ›ÓË 6 6 8

KÏÈÓ‰·Ì˘Î›ÓË 8 8 8

¢ÔÍ˘Î˘ÎÏ›ÓË 12-24 12-24 12-24

EÚ˘ıÚÔÌ˘Î›ÓË 6 6 6

MÂÙÚÔÓÈ‰·˙fiÏË 8 8 12-16

¶ÂÓÈÎÈÏÏ›ÓË V 6 6 6

TÂÙÚ·Î˘ÎÏ›ÓÂ˜ 6 AÔÊ˘Á‹ AÔÊ˘Á‹ XÔÚ‹ÁËÛË˜ XÔÚ‹ÁËÛË˜

B·ÓÎÔÌ˘Î›ÓË 6 72-240 240

ÍÂÎÔ‡Ú·ÛÙÔ˜. O‡Ùˆ˜ ‹ ¿ÏÏˆ˜, ÌÂÁ¿ÏË ÚÔÛÔ¯‹ ··ÈÙÂ›Ù·È ÒÛÙÂ ÔÈ ̄ ÂÈ-ÚÔ˘ÚÁÈÎ¤˜ ÂÂÌ‚¿ÛÂÈ˜ Ó· ÌËÓ Â›Ó·È ÂÎÙÂÙ·Ì¤ÓÂ˜ Î·È Ó·Á›ÓÂÙ·È Î·Ï‹ Û˘ÚÚ·Ê‹ ÙÔ˘ ÙÚ·‡Ì·ÙÔ˜.- I‰È·›ÙÂÚ· ‰Â fiÛÔÓ ·ÊÔÚ¿ ÛÙÔ Â›‰Ô˜ ÙË˜ ·ÓÙÈ‚›ˆÛË˜ Î·ÈÙÔ Î·Ù¿ÏÏËÏÔ ‰ÔÛÔÏÔÁÈÎfi Û¯‹Ì· ÛÙÔ˘˜ ·ÈÌÔÎ·ı·ÈÚfi-ÌÂÓÔ˘˜ ·ÛıÂÓÂ›˜, ‰Â‰ÔÌ¤ÓË˜ ÙË˜ ÔÏ˘ÏÔÎfiÙËÙ·˜ ÙˆÓ·Ú·Ì¤ÙÚˆÓ Ô˘ Ú¤ÂÈ Ó· ÂÎÙÈÌËıÔ‡Ó, ·˘Ù¿ ÂÍ·ÙÔÌÈ-ÎÂ‡ÔÓÙ·È Î·È ¤ÙÛÈ Â›Ó·È ÛÎfiÈÌÔ Ó· Î·ıÔÚ›˙ÔÓÙ·È ÌfiÓÔ Î·-ÙfiÈÓ Û˘ÓÂÚÁ·Û›·˜ ÙˆÓ ıÂÚ·fiÓÙˆÓ È·ÙÚÒÓ (Ô‰ÔÓÙÈ¿-ÙÚÔ˘ Î·È ÓÂÊÚÔÏfiÁÔ˘).- H Ì¤ÙÚËÛË ÙË˜ ›ÂÛË˜ ‰ÂÓ Ú¤ÂÈ Ó· Á›ÓÂÙ·È ÛÙÔ ¯¤ÚÈfiÔ˘ ˘¿Ú¯ÂÈ Ë ·ÚÙËÚÈÔÊÏÂ‚ÈÎ‹ ÂÈÎÔÈÓˆÓ›· (fistula).- H Û˘ÓÂ‰Ú›· Ó· Â›Ó·È ÌÈÎÚ‹˜ ‰È¿ÚÎÂÈ·˜.- T¤ÏÔ˜, Ô Ô‰ÔÓÙ›·ÙÚÔ˜ Ú¤ÂÈ Ó· Â›Ó·È ÁÓÒÛÙË˜ ÙÔ˘ ÁÂ-ÁÔÓfiÙÔ˜ fiÙÈ ÔÛÔÛÙfi ÙˆÓ ·ÈÌÔÎ·ı·ÈÚfiÌÂÓˆÓ ·ÛıÂÓÒÓÂÌÊ·Ó›˙ÂÈ ÊÔÚÂ›· ÙˆÓ ÈÒÓ ÙË˜ Ë·Ù›ÙÈ‰·˜ -B Î·È -C (HBVÎ·È HCV) ‹ ÙÔ˘ HIV. ™‹ÌÂÚ· Ù· ÔÛÔÛÙ¿ ·˘Ù¿ ¤¯Ô˘Ó Î·-Ù¿ ÔÏ‡ ÌÂÈˆıÂ› ÏfiÁˆ ÙË˜ ÂÏ¿ÙÙˆÛË˜ ÙˆÓ ÌÂÙ·ÁÁ›ÛÂˆÓ,ÙË˜ ÚÔfi‰Ô˘ ÛÙÔÓ ¤ÏÂÁ¯Ô ÙÔ˘ ·›Ì·ÙÔ˜ Î·È ÙÔ˘ ÂÌ‚Ô-ÏÈ·ÛÌÔ‡ ÁÈ· ÙËÓ Ë·Ù›ÙÈ‰· B51,60-64.

™YM¶EPA™MATA- AÛıÂÓÂ›˜ ÌÂ XNN ·ÚÔ˘ÛÈ¿˙Ô˘Ó ·˘ÍËÌ¤ÓË Û˘¯ÓfiÙËÙ·ÛÙÔÌ·ÙÈÎÒÓ ÓfiÛˆÓ (Î˘Ú›ˆ˜ ÚÔ‚Ï‹Ì·Ù· ÂÚÈÔ‰ÔÓÙ›Ô˘),ÔÚÈÛÌ¤ÓÂ˜ ·fi ÙÈ˜ ÔÔ›Â˜ ÌÔÚÔ‡Ó ÌÂ ÙË ÛÂÈÚ¿ ÙÔ˘˜ Ó·ÂËÚÂ¿ÛÔ˘Ó ‰˘ÛÌÂÓÒ˜ ÙËÓ ÁÂÓÈÎ‹ ˘ÁÂ›·.- O Ô‰ÔÓÙ›·ÙÚÔ˜ Ú¤ÂÈ Ó· Â›Ó·È ÁÓÒÛÙË˜ ·˘ÙÒÓ ÙˆÓ ·Ï-ÏËÏÂÈ‰Ú¿ÛÂˆÓ Î·È Ó· Û˘Ì‚¿ÏÏÂÈ ÛÙË ‰È·ÛÊ¿ÏÈÛË Î·ÏÔ‡ÂÈ¤‰Ô˘ ÛÙÔÌ·ÙÈÎ‹˜ ˘ÁÂ›·˜ ÛÙÔ˘˜ ÓÂÊÚÔ·ıÂ›˜, È‰È·›-ÙÂÚ· ‰Â ÛÙÔ˘˜ ·ÛıÂÓÂ›˜ ÌÂ XNA ÔÈ ÔÔ›ÔÈ ·ÚÔ˘ÛÈ¿˙Ô˘Ó·ÓÔÛÔÎ·Ù·ÛÙÔÏ‹ Î·È ¤¯Ô˘Ó ·˘ÍËÌ¤ÓÔ Î›Ó‰˘ÓÔ ·Ó¿Ù˘-ÍË˜ ÏÔÈÌÒÍÂˆÓ Î·È ÊÏÂÁÌÔÓÒÓ.- °È· ÙËÓ ·ÓÙÈÌÂÙÒÈÛË ÙˆÓ ·ÛıÂÓÒÓ ·˘ÙÒÓ ÛÙÔ Ô‰Ô-ÓÙÈ·ÙÚÂ›Ô ̆ ¿Ú¯Ô˘Ó ÛËÌÂ›· Ô˘ ̄ Ú‹˙Ô˘Ó È‰È·›ÙÂÚË˜ ÚÔ-ÛÔ¯‹˜, ıÂˆÚÂ›Ù·È ‰Â ÂÈ‚Â‚ÏËÌ¤ÓË Ë Û˘ÓÂÚÁ·Û›· ÙÔ˘Ô‰ÔÓÙÈ¿ÙÚÔ˘ ÌÂ ÙÔÓ ıÂÚ¿ÔÓÙ· ÓÂÊÚÔÏfiÁÔ.

SUMMARY

Chronic kidney disease and oral healthDimitriou A., Zervou-Valvi F.


Chronic kidney disease (CKD) is a term for a variety ofchronic conditions that result in compromised kidneyfunction, which is measured as the glomelural filtration rate(GRF). Chronic kidney disease is a public health problemthat is undiagnosed in a significant number of cases andcan lead to renal failure. Chronic renal failure (CRF)represents the end stage of CKD and is characterized bythe progressive and irreversible decline in the number of

functioning nephrons and may be defined clinically as astate of systemic poisoning of the entire body. The aim ofthis study is to review the available evidence on the mutualrelationship between CKD and oral health, as well as topresent guidelines to the clinician for the dentalmanagement of these patients.

Several studies report higher levels of dental plaqueand calculus accumulation in CRF patients on hemodialysisthan the healthy control individuals. Severity of periodontaldisease in CRF group is associated with age, diabetesmellitus, smoking and total duration on dialysis. There isevidence that periodontitis is an important source of chronicinflammation that can deteriorate general health of CRFpatients. Elevated serum levels of C-reactive protein andinterleukin-6 are present in patients with severe periodontaldisease. Recently a number of studies found that severeperiodontal disease diminishes glomerular renal filtrationand increases complications of CRF and mortality of thepatients. Intensive periodontal treatment also causessignificant reduction of inflammatory mediators andimprovement of hemodialysis response.There is no statistically significant difference in theprevalence of dental caries of CRF patients comparingwith that of healthy individuals. In fact caries index is oftennoticeably lower in these patients due to higher levels ofsalivary urea that increases pH levels. Common oral findings are pale mucosa, petechiae andecchymoses. Renal osteodystrophy may causedemineralization at the mandible and the maxilla. CRF patients require special considerations during dentaltreatment, mainly with regard to risk of excessive bleeding,risk of infection and medications used. It is necessary fordentists to work in cooperation with nephrologists whoconsult for the systemic condition of this patient group.

Key words: chronic kidney disease; chronic renal failure;periodontal disease; caries prevalence; dental management

BIB§IO°PAºIA1. AÁÚÔÁÈ¿ÓÓË˜ B, KÔ‡ÙÛÈÎÔ˜ ¢K: XÚfiÓÈ· ÓÂÊÚÈÎ‹ ·ÓÂ¿Ú-

ÎÂÈ·. ™ÙÔ: P¿ÙË˜ ™A: EÛˆÙÂÚÈÎ‹ ¶·ıÔÏÔÁ›·, Aı‹Ó·. EÈ-ÛÙËÌÔÓÈÎ¤˜ EÎ‰fiÛÂÈ˜ «°Ú. K. ¶·ÚÈÛÈ¿ÓÔ˜». 1996 : 872-880.

2. Levey AS, Coresh J, Balk E, Kausz AT, Levin A, Steffes MWet al: National Kidney Foundation practice guidelines forchronic kidney disease: evaluation, classification andstratification. Ann Intern Med 2003; 15 (139): 137-147.

3. Jacobson H.R., Striker G.E., Saulo K. The principles andpractice of nephrology. 2nd ed. St. Louis. Mosby. 1995: 596.

4. Ross EA, Caruso JM: AÈÌÔÎ¿ı·ÚÛË Î·È Û˘ÓÂ¯Â›˜ ıÂÚ·Â›Â˜.™ÙÔ: Wilcox CS, Ticher CC. EÁ¯ÂÈÚ›‰ÈÔ ÓÂÊÚÔÏÔÁ›·˜ Î·È ˘-¤ÚÙ·ÛË˜. 5Ë ¤Î‰ÔÛË. Aı‹Ó·. EÎ‰fiÛÂÈ˜ PÔÙfiÓÙ·. 2007:269-309.

5. Kato S, Chmielewski M, Honda H, Pecoits-Filho R, MatusoS, Yuzawa Y et al: Aspects of immune dysfunction in end-stage renal disease. Clin J Amer Soc Nephrol 2008; 3: 1526-1533.

6. Bayractar G, Kurtulus I, Kazancioglu R, Bayramgurler I,


∞Ó·ÛÎfiËÛË

Cintan S, Bural C et al: Oral health and inflammation inpatients with end-stage renal failure. Perit Dial Int 2009;29(4): 472-479.

7. Reid CL, Rahimtoola SH: Infective endocarditis in chronicrenal failure. In: The heart and renal disease. New York.Churchill Livinstone. 1984: 189-208.

8. Jofre R, Rodriguez-Benitez P, Lopez-Gomez JM, Perez-GarciaR: Inflammatory syndrome in patients on hemodialysis. J AmSoc Nephrol 2006; 17 (12 Suppl 3): 274-280.

9. Stevinkel P, Pecoits-Filho R, Lindholm B: For the DialGeneConsortium. Gene polymorphism association studies indialysis: the nutrition-inflammation axis. Semin Dial 2005;18: 322-30.

10. Flemmig TF : Periodontitis. Ann Periodontol 1999; 4: 32-38.11. Scheutz F, Matee MI, Andsager L, Holm AM, Moshi J,

Kagoma C et al: Is there an association between periodontalcondition and HIV infection? J Clin Periodontol 1997; 24:580-587.

12. Fisher MA, Taylor GW, Shelton BJ, Jamerson KA, RahmanM, Ojo AO et al: Periodontal disease and other nontraditional risk factors for CKD. Am J Kidn Dis 2008; 51: 45-52.

13. Kotanko P: Chronic inflammation in dialysis patients-periodontal disease, the new kid on the block. Oral Dis 2008;14(1): 8-9.

14. Madianos PN, Bobetsis YA, Kinane DF: Generation ofinflammatory stimuli: how bacteria set up inflammatoryresponses in the gingiva. Clin Periodontol 2005; 32(6): 65-71.

15. Castillo A, Mesa F, Liebana J, Garcia-Martinez O, Ruiz S,Garcia-Valdecasas J et al: Periodontal and oralmicrobiological status of an adult population undergoinghaemodialysis: a cross sectional study. Oral Dis 2007; 13:198-205.

16. Buhlin K, Gustaffson A, Pockley AG, Frostegard J, Klinge B:Risk factors for cardiovascular disease in patients withperiodontitis. Eur Heart J 2003; 24: 299-2107.

17. Garcia RI, Henshaw MM, Krall EA: Relationship betweenperiodontal disease and systemic health. Periodontol 2001;25: 21-36.

18. Scannapieco FA, Panesar M: Periodontitis and chronickidney disease. J Periodontol 2008; 79: 1617-1619.

19. Page RC: The pathobiology of periodontal diseases mayaffect systemic diseases: inversion of a paradigm. AnnPeriodontol 1998; 3: 108-120.

20. Williams RC, Offenbacher S: Periodontal medicine: theemergency of a new branch of periodontology. Periodontol2000; 23: 9-12.

21. Kadiroglou AK, Kadiroglou ET, Sit D, Dag A, Yilmaz ME :Periodontotis is an important and occult source ofinflammation in hemodialysis patients. Blood Purif 2006; 24:400-404.

22. Paraskevas S, Huizinga JD, Loos BG: A systematic reviewand metaanalyses on C-reactive protein in relation toperiodontitis. J Clin Periodontol 2008; 35: 277-290.

23. Noack B, Genco RJ, Trevisan M, Grossi S, Zambon JJ, DeNardin E: Periodontal infections contribute to elevatedsystemic C-reactive protein level. J Periodontol 2001; 72:1221-1227.

24. Glurich I, Grossi S, Albini B, Ho A, Shah R, Zeid M et al:Systemic inflammation in cardiovascular and periodontaldisease: comparative study. Clin Diagn Lab Immunol 2002;9: 425-432.

25. Atassi F: Oral home care and reasons for seeking dentalcare by individuals on renal dialysis. J Contemp Dent Pract2002; 3: 31-41.

26. Tollefsen T, Johannsen JR: The periodontal status ofprospective and renal transplant patients. Comparison withsystemically healthy subjects. J Periodont Res 1985; 20:220-226.

27. Marakoglu I, Gursoy UK, Demirer S, Sezer H: Periodontalstatus of chronic renal failure patients receivinghemodialysis. Yonsei Med J 2003; 44: 648-652.

28. Duran I, Erdemir E: Periodontal treatment needs of patientswith renal disease receiving haemodialysis. Int Dent J 2004;54: 274-278.

29. Gavalda C: Renal hemodialysis patients: oral, salivary,dental and periodontal findings in 105 adult cases. Oral Dis1999; 5: 299-302.

30. Bots C, Poorterman J, Brand H, Kalsbeek H, VanAmerongen B, Veerman E et al: The oral health status ofdentate patients with chronic renal failure undergoingdialysis therapy. Oral Dis 2006; 12: 176-180.

31. Epstein SR, Mandel I, Scopp IW: Salivary composition andcalculus formation in patients undergoing hemodialysis. JPeriodontol 1980; 51: 336-338.

32. Bayractar G, Kurtulus I, Duranduryan A, Cintan S,Kazangioglu R, Yildiz A et al: Dental and periodontal findingsin hemodialysis patients. Oral Dis 2007; 13: 393-397.

33. Bayractar G, Kurtulus I, Kazangioglu R, Bayramgurler I,Cintan S, Bural C et al: Evaluation of periodontal parametersin patients undergoing peritoneal dialysis or hemodialysis.Oral Dis 2008; 14: 185-189.

34. Rahmati MA, Craig RG, Homel P, Kaysen GA, Levin NW:Serum markers of periodontal disease status andinflammation in hemodialysis patients. Am J Kidney Dis2002; 40: 983-9.

35. Kshirsagar AV, Offenbacher S, Moss KL, Barros SP, BeckJD: Antibodies to periodontal organisms are associated withdecreased Kidney Function. The dental atherosclerosis RiskIn Communities Study. Blood Purif 2007; 25: 125-132.

36. Kshirsagar AV, Moss KL, Elter JR, Beck JD, Offenbacher S,Falk RJ: Periodontal disease is associated with renalinsufficiency in the Atherosclerosis Risk In Communities(ARIC) study. Am J Kidney Dis 2005; 45: 650-657.

37. Chen LP, Chiank CK, Chan CP, Hung KY, Huang CS: Doesperiodontitis reflect inflammation and malnutrition status inhemodialysis patients? Am J of Kidney Dis 2006; 47: 815-822.

38. Kshirsagar AV, Craig RG, Beck JD, Moss K, Offenbacher S,Kotanko P et al: Severe periodontitis is associated with lowserum albumin among patients on maintenancehemodialysis therapy. Clin J Am Soc Nephrol 2007; 2: 239-44.

39. Franek E, Blaschyk R, Kolonko A, Mazur-Psonka L,Langowska-Adamczyk H, Kokot F et al: Chronicperiodontitis in hemodialysis patients with chronic kidneydisease is associated with elevated serum C-reactive proteinconcentration and greater intima-media thickness of thecarotid artery. J Nephrol 2006; 19: 346-51.

40. Kshirsagar AV, Craig RG, Moss KL, Beck JD, Offenbacher S,Kotanko P et al: Periodontal disease adversely affects thesurvival of patients with end-stage renal disease. Kidney Int2009; 75(7): 746-751.

41. Mustapha IZ, Debrey S, Oladubu M, Ugarte R: Markers ofsystemic bacterial exposure in periodontal disease andcardiovascular disease risk: a systematic review and meta-analysis. J Periodontol 2007; 78: 2289-2302.

42. Mealey BL: Periodontal disease and diabetes. A two-waystreet. J Am Dent Assoc 2006; 137 Suppl: 26S-31S.

43. Ioannidou E, Malekzadeh T, Dongari-Bagtzoglou A: Effect ofperiodontal treatment on serum C-reactive protein levels: a

42

∞Ó·ÛÎfiËÛË


systematic review and meta-analysis. J Periodontol 2006;77: 1635-42.

44. °ÏËÓÔ‡ TM, ¢ËÌËÙÚ›Ô˘ A, AÁÚ·ÊÈÒÙË˜ A, KÔÚÔÌ¿ÓÙ˙Ô˜ ¶A,ZÂÚ‚Ô‡-B¿Ï‚Ë º™, BÚfiÙÛÔ˜ I Î·È Û˘Ó: E›‰Ú·ÛË ÙË˜ ÂÚÈÔ-‰ÔÓÙÈÎ‹˜ ıÂÚ·Â›·˜ ÛÙ· Â›Â‰· Û˘ÛÙËÌ·ÙÈÎ‹˜ ÊÏÂÁÌÔÓ‹˜·ÈÌÔÎ·ı·ÈÚfiÌÂÓˆÓ ·ÛıÂÓÒÓ ÌÂ ÙÂ¯ÓËÙfi ÓÂÊÚfi. 30Ô ¶·ÓÂÏ-Ï‹ÓÈÔ O‰ÔÓÙÈ·ÙÚÈÎfi ™˘Ó¤‰ÚÈÔ, Aı‹Ó·, 22-24/10/2010.

45. Ioannidou E, Fares G: The periodontal patient and chronickidney disease. Analecta Periodontologica 2009; 20: 167-179.

46. Bayractar G, Kazancioglu R, Bozfacioglu S, Yildiz A, Ark E:Evaluation of salivary parameters and dental status in adulthemodialysis patients. Clin Nephrol 2004; 62: 380-383.

47. Proctor R, Kumar N, Stein A, Moles D, Porter S: Oral anddental aspects of chronic renal failure. J Dent Res 2005 ; 84:199-208.

48. Ziebolz D, Fischer P, Hornecker E, Mausberg RF: Oralhealth of hemodialysis patients: a cross-sectional study attwo German dialysis centers. Hemodial Int 2012; 16(1): 69-75.

49. Guzeldemir E, Toygar HU, Tasleden B, Torun D: Oral health-related quality of life and periodontal health status in patientsundergoing hemodialysis. J Am Dent Assoc 2009; 140(10):1283-1293.

50. Sobrado-Marinho JS, Tomas-Carmona I, Loureiri A,Limeres-Posse J, Garcia-Caballero L, Diz-Dios P: Oral healthstatus in patients with moderate-severe and terminal renalfailure. Med Oral Patol Oral Cir Bucal 2007; 12: 305-310.

51. De Rossi S, Glick M: Dental considerations for the patientwith renal disease receiving hemodialysis. JADA 1996; 127:211-219.

52. Thorman R, Neovius M, Hylander B: Prevalence and earlydetection of oral fungal infection: a cross-sectionalcontrolled study in a group of Swedish end-stage renaldisease patients. Scand J Urol Nephrol 2009; 43(4): 325-330.

53. ZÂÚ‚Ô‡-B¿Ï‚Ë º, ¶ÂÚ‰ÈÎ¿ÎË ¶, ¶ËÏ·ÏËÙfi˜ ¶, ¢ÚÔ‡˙·˜ A,¶··‰¿ÎË˜ °: EÎ‰ËÏÒÛÂÈ˜ ·fi ÙÔÓ ‚ÏÂÓÓÔÁfiÓÔ ÙÔ˘ ÛÙfiÌ·-ÙÔ˜ ÛÂ ·ÛıÂÓÂ›˜ Ô˘ ˘Ô‚¿ÏÏÔÓÙ·È ÛÂ ¯ÚfiÓÈ· ÂÚÈÔ‰ÈÎ‹ ·È-ÌÔÎ¿ı·ÚÛË. 5Ô ¶·ÓÂÏÏ‹ÓÈÔ ™˘Ó¤‰ÚÈÔ °ÂÓÈÎ‹˜ I·ÙÚÈÎ‹˜,K¤ÚÎ˘Ú·, 22-25/4/1993.

54. §¿ÛÎ·ÚË˜ °: ™ÙÔÌ·ÙÔÏÔÁ›·. ŒÁ¯ÚˆÌÔ˜ ÕÙÏ·˜. 2Ë ¤Î‰ÔÛË.Aı‹Ó·. I·ÙÚÈÎ¤˜ EÎ‰fiÛÂÈ˜ «§›ÙÛ·˜». 1998: 358-360.

55. Bossola M, Tazza L: Xerostomia in patients on chronichemodialysis. Nat Rev Nephrol 2012;17: 8(3): 176-182.

56. AÁÁÂÏfiÔ˘ÏÔ˜ A, ¶··ÓÈÎÔÏ¿Ô˘ ™, AÁÁÂÏÔÔ‡ÏÔ˘ E: ™‡Á-¯ÚÔÓË ÛÙÔÌ·ÙÈÎ‹ Î·È ÁÓ·ıÔÚÔÛˆÈÎ‹ ·ıÔÏÔÁ›·. 3Ë ¤Î‰Ô-ÛË. Aı‹Ó·. I·ÙÚÈÎ¤˜ EÎ‰fiÛÂÈ˜ «§›ÙÛ·˜». 2000: 743-744.

57. Zervou-Valvi F, Chondros D, Kaloheretis P, Drouzas A,Pilalitos P, Mitsopoulos A et al: Roentgenographic changesof the jaws in patients on long-term haemodialysis therapy.31st Congress of the European Renal Association,European Dialysis and Transplant Association, ViennaAustria, 3-6/6/1994.

58. Mandalunis PM, Steimetz T, Castiglione JL, Ubios AM:Alveolar Bone Response in an Experimental Model of RenalFailure and Periodontal Disease: A Histomorphometric andHistochemical Study. J Periodontol 2003; 74: 1803-1807.

59. Yamamoto S, Kazama JJ, Maruyama H, Nishi S, Narita I,Gejyo F: Patients undergoing dialysis therapy for 30 years ormore survive with serious osteoarticular disorders. ClinNephrol 2008; 70(6): 496-502.

60. Saif I, Adkins A, Kewley V, Woywodt A, Brookes V: Routineand emergency management guidelines for the dentalpatient with renal disease and kidney transplant. Part 1. DentUpdate 2011; 38(3): 179-182, 185-186.

61. Sharma DC, Pradeep AR: End stage renal disease and itsdental management. NY State Dent J 2007; 73(1): 43-47.

62. Vesterinen M, Ruokonen H, Leivo T, Honkanen AM,Honkanen E, Kari K et al: Oral health and dental treatment ofpatients with renal disease. Quintessence 2007; 38(3): 211-219.

63. Tong DC, Walker RJ: Antibiotic prophylaxis in dialysispatients undergoing invasive dental treatment. Nephrology(Carlton) 2004; 9(3): 167-170.

64. Jover Cervero A, Bagan JV, Jimenez Soriano Y, PovedaRoda R: Dental management in renal failure: patients ondialysis. Med Oral Patol Oral Cir Bucal 2008; 13(7): 419-426.

65. EıÓÈÎfi˜ OÚÁ·ÓÈÛÌfi˜ º·ÚÌ¿ÎˆÓ: EıÓÈÎfi ™˘ÓÙ·ÁÔÏfiÁÈÔ.Aı‹Ó·. EÎ‰fiÛÂÈ˜ EOº. 2007

66. ¶ÂÊ¿ÓË˜ A: AÚ¯¤˜ OÚıÔÏÔÁÈÎ‹˜ AÓÙÈÌÈÎÚÔ‚È·Î‹˜ XËÌÂÈÔ-ıÂÚ·Â›·˜ ÛÙËÓ Î·ıËÌÂÚÈÓ‹ I·ÙÚÈÎ‹ ¶Ú¿ÍË. KÏÈÓÈÎfi ºÚÔÓÙÈ-ÛÙ‹ÚÈÔ ¶ÓÂ˘ÌÔÓÔÏÔÁ›·˜ 2010-2011. NN£A, «H ™ˆÙËÚ›·».http://www.pneumonologia.gr/articlefiles/arhes-antimikroviakis-chimiotherapias/ Ÿˆ˜ ·˘Ùfi ÂÌÊ·Ó›˙ÂÙ·ÈÙËÓ 1/11/12.


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H ™ÙÔÌ·ÙÔ‰˘Ó›· Â›Ó·È ¤Ó·˜ ÂÓ‰ÔÛÙÔÌ·ÙÈÎfi˜ fiÓÔ˜ ÌÂ ¯·Ú·ÎÙ‹Ú· Î·‡ÛÔ˘. EÌÊ·Ó›˙ÂÙ·È ÛÂ ¿-ÙÔÌ· ¿Óˆ ÙˆÓ 50 ÂÙÒÓ, Û˘Ó‹ıˆ˜ Á˘Ó·›ÎÂ˜. EÓÙÔ›˙ÂÙ·È Û˘¯ÓfiÙÂÚ· ÛÙË ÁÏÒÛÛ·. H ¤ÓÙ·Û‹ ÙÔ˘ÔÈÎ›ÏÏÂÈ ·fi ‹È· ÂÓfi¯ÏËÛË ¤ˆ˜ ¤ÓÙÔÓÔ fiÓÔ. H ·ÈÙÈÔÏÔÁ›· ÙÔ˘ ÂÚÈÏ·Ì‚¿ÓÂÈ ÙÔÈÎÔ‡˜ ·-Ú¿ÁÔÓÙÂ˜, Û˘ÛÙËÌ·ÙÈÎ¿ ÓÔÛ‹Ì·Ù·, „˘¯ÔÁÂÓ‹ ·›ÙÈ· Î·È ·ÏÏ·Á¤˜ ÙË˜ ÔÛfiÙËÙ·˜ ‹ ÔÈfiÙËÙ·˜ÙÔ˘ ÛÈ¤ÏÔ˘. TÔÈÎÔ› ·Ú¿ÁÔÓÙÂ˜ Ô˘ ¤¯Ô˘Ó ÂÓÔ¯ÔÔÈËıÂ› Â›Ó·È: ÁÂˆÁÚ·ÊÈÎ‹ ÁÏÒÛÛ·, Î·ÓÙÈ-ÓÙ›·ÛË, Á·Ï‚·ÓÈÎ¿ ÚÂ‡Ì·Ù· Î·È ·ÏÏÂÚÁ›· ÛÙÔ ·ÎÚ˘ÏÈÎfi Ô‰ÔÓÙÔÛÙÔÈ¯ÈÒÓ. OÈ Û˘ÛÙËÌ·ÙÈÎÔ› ·Ú¿ÁÔÓÙÂ˜ ÂÚÈÏ·Ì‚¿ÓÔ˘Ó: ÂÏÏÂ›„ÂÈ˜ ‚ÈÙ·ÌÈÓÒÓ B, ÛÈ‰ËÚÔÂÓÈÎ‹ ·Ó·ÈÌ›·,‰È·‚‹ÙË, ·˘ÙÔ¿ÓÔÛ· ÓÔÛ‹Ì·Ù·, ÂÌÌËÓfi·˘ÛË. æ˘¯È·ÙÚÈÎ¤˜ ‰È·Ù·Ú·¯¤˜ Ô˘ ÂÌÏ¤ÎÔÓÙ·È Â›Ó·È: Î·ÚÎÈÓÔÊÔ‚›·, ·ÓÙÈ‰Ú·ÛÙÈÎ‹ Î·Ù¿ıÏÈ„Ë Î·È¿Á¯Ô˜. NÂÒÙÂÚÂ˜ ·fi„ÂÈ˜ ˘ÔÛÙËÚ›˙Ô˘Ó fiÙÈ Ë ÛÙÔÌ·ÙÔ‰˘Ó›· Â›Ó·È ¤Ó·˜ ÓÂ˘ÚÔ·ıËÙÈÎfi˜ fi-ÓÔ˜ Ô˘ ÔÊÂ›ÏÂÙ·È Â›ÙÂ ÛÂ ‚Ï¿‚Ë Î¿ÔÈˆÓ ÎÚ·ÓÈ·ÎÒÓ ÓÂ‡ÚˆÓ Â›ÙÂ ÛÂ ÙÚ·‡Ì· Î¿ÔÈÔ˘ ÙÌ‹Ì·-ÙÔ˜ ÙÔ˘ ÎÂÓÙÚÈÎÔ‡ ÓÂ˘ÚÈÎÔ‡ Û˘ÛÙ‹Ì·ÙÔ˜. H ·ÓÙÈÌÂÙÒÈÛË ÙË˜ ÛÙÔÌ·ÙÔ‰˘Ó›·˜ ··ÈÙÂ› ÙË Ï‹„Ë ÂÓfi˜ ÂÎÙÂÓÔ‡˜ Î·È ÏÂÙÔÌÂÚÔ‡˜ ÈÛÙÔÚÈ-ÎÔ‡ Ì·˙› ÌÂ ·ÈÌ·ÙÔÏÔÁÈÎfi Î·È ‚ÈÔ¯ËÌÈÎfi ¤ÏÂÁ¯Ô ÒÛÙÂ Ó· ·ÓÂ˘ÚÂıÔ‡Ó ‹ ·ÔÎÏÂÈÛıÔ‡Ó ÓÔÛ‹-Ì·Ù· Ô˘ ÂÌÏ¤ÎÔÓÙ·È ÛÙËÓ ·ÈÙÈÔ·ıÔÁ¤ÓÂÈ·. °È· ÙË ıÂÚ·Â›· ¤¯Ô˘Ó ‰ÔÎÈÌ·ÛıÂ›: ÙÔÈÎ‹ ÂÊ·ÚÌÔÁ‹ Î·„·˚Î›ÓË˜, ÛÙÔÌ·ÙÈÎ¤˜ Ï‡ÛÂÈ˜ ÌÂ ÛÔ-‰fiÓÂÚÔ Î·ıÒ˜ Î·È Û˘ÛÙËÌ·ÙÈÎ‹ ¯ÔÚ‹ÁËÛË ÏÈÔ˚ÎÔ‡ ÔÍ¤Ô˜, ÙÚÈÎ˘ÎÏÈÎÒÓ ·ÓÙÈÎ·Ù·ıÏÈÙÈÎÒÓ,‚ÂÓ˙Ô‰È·˙ÂÈÓÒÓ Î·È ·ÓÙÈÂÈÏËÙÈÎÒÓ. H ıÂÚ·Â›· ÙË˜ ÛÙÔÌ·ÙÔ‰˘Ó›·˜ Â›Ó·È ‰˘Û¯ÂÚ‹˜ Î·È ·-·ÈÙÂ› ¯ÚfiÓÔ Î·È ˘ÔÌÔÓ‹ ÂÎ Ì¤ÚÔ˘˜ ÙÔ˘ ıÂÚ¿ÔÓÙ·.™ÎÔfi˜ ÙË˜ ·ÚÔ‡Û·˜ ÂÚÁ·Û›·˜ Â›Ó·È Ë Î·Ù·ÁÚ·Ê‹ ÙˆÓ ̄ ·Ú·ÎÙËÚÈÛÙÈÎÒÓ ÙÔ˘ fiÓÔ˘ ÙË˜ ÛÙÔ-Ì·ÙÔ‰˘Ó›·˜, ÙˆÓ ·ÈÙ›ˆÓ Ô˘ ¤¯Ô˘Ó ÂÌÏ·ÎÂ› ÛÙËÓ ·ıÔÁ¤ÓÂÈ· ÙË˜ Î·ıÒ˜ Î·È ÙˆÓ ‰È·ÊfiÚˆÓıÂÚ·ÂÈÒÓ Ô˘ ¤¯Ô˘Ó ‰ÔÎÈÌ·ÛıÂ› ÁÈ· ÙËÓ ·ÓÙÈÌÂÙÒÈÛ‹ ÙË˜.


§¤ÍÂÈ˜ ÎÏÂÈ‰È¿: ÂÓ‰ÔÛÙÔÌ·ÙÈÎfi˜ fiÓÔ˜, Î·˘Û·ÏÁ›·, ÁÏˆÛÛÔ‰˘-Ó›·, „˘¯ÔÏÔÁÈÎ¤˜ ‰È·Ù·Ú·¯¤˜.

* O‰ÔÓÙ›·ÙÚÔ˜, EÈÌÂÏ‹ÙÚÈ· A’ E™Y, ¢Ú O‰ÔÓÙÈ·ÙÚÈÎ‹˜, MSc

ÿ‰Ú˘Ì· ÚÔ¤ÏÂ˘ÛË˜:O‰ÔÓÙÈ·ÙÚÈÎfi TÌ‹Ì· K¤ÓÙÚÔ˘ YÁÂ›·˜ MÂÁ¿ÚˆÓ

H ÂÚÁ·Û›· ·ÚÔ˘ÛÈ¿ÛıËÎÂ ˆ˜ ÂÏÂ‡ıÂÚË ·Ó·ÎÔ›ÓˆÛË ÛÙÔ 4Ô ¶·ÓÂÏÏ‹ÓÈÔ ™˘Ó¤‰ÚÈÔ NÔÛÔÎÔÌÂÈ·Î‹˜ O‰ÔÓÙÈ·ÙÚÈÎ‹˜30/9-2/10/2011, Aı‹Ó·

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ÓÈfiÙÂÚ· Ë ÛÙÔÌ·ÙÔ‰˘Ó›· ÌÔÚÂ› Ó· Û˘ÓÔ‰Â‡ÂÙ·È ·fi Ó·˘-Ù›·, ˙¿ÏË ‹ ‰È·Ù·Ú·¯¤˜ ÛÙË ÁÂ‡ÛË1. ™Â ÂÚÈÛÛfiÙÂÚÔ˘˜ ·fi ÙÔ˘˜ ÌÈÛÔ‡˜ ·ÛıÂÓÂ›˜ Ë ¤Ó·ÚÍËÙË˜ ÛÙÔÌ·ÙÔ‰˘Ó›·˜ Â›Ó·È ·˘ÙfiÌ·ÙË ¯ˆÚ›˜ Ó· ·Ó·ÁÓˆÚ›-˙ÂÙ·È Î¿ÔÈÔ˜ ÂÎÏ˘ÙÈÎfi˜ ·Ú¿ÁÔÓÙ·˜, ·Ó Î·È ÙÔ 1/3 ÙˆÓ·ÛıÂÓÒÓ Û˘Ó‰˘¿˙ÂÈ ÙËÓ ¤Ó·ÚÍË ÙË˜ ÛÙÔÌ·ÙÔ‰˘Ó›·˜ ÌÂÎ¿ÔÈ· Ô‰ÔÓÙÈ·ÙÚÈÎ‹ Ú¿ÍË ‹ ÌÂ ÙËÓ ¤Ó·ÚÍË Î¿ÔÈ·˜Ê·ÚÌ·ÎÂ˘ÙÈÎ‹˜ ·ÁˆÁ‹˜4. §›ÁÂ˜ ÏËÚÔÊÔÚ›Â˜ ˘¿Ú¯Ô˘ÓÂ›ÛË˜ ÁÈ· ÙËÓ ÔÚÂ›· ÙË˜ ÛÙÔÌ·ÙÔ‰˘Ó›·˜. A˘ÙfiÌ·ÙË ›·-ÛË ·Ó·Ê¤ÚÂÙ·È ÛÙ· 2/3 ÙˆÓ ÂÚÈÙÒÛÂˆÓ ÌÂÙ¿ ·fi 6-7¯ÚfiÓÈ·1-7.™ÎÔfi˜ ÙË˜ ·ÚÔ‡Û·˜ ÂÚÁ·Û›·˜ Â›Ó·È Ë Î·Ù·ÁÚ·Ê‹ ÙˆÓ¯·Ú·ÎÙËÚÈÛÙÈÎÒÓ ÙÔ˘ fiÓÔ˘ ÙË˜ ÛÙÔÌ·ÙÔ‰˘Ó›·˜, ÙˆÓ ·È-Ù›ˆÓ Ô˘ ÂÌÏ¤ÎÔÓÙ·È ÛÙËÓ ·ıÔÁ¤ÓÂÈ· ÙË˜ Î·ıÒ˜ Î·ÈÙˆÓ ‰È·ÊfiÚˆÓ Ê·ÚÌ·ÎÂ˘ÙÈÎÒÓ ·ÁˆÁÒÓ Ô˘ ¤¯Ô˘Ó ‰ÔÎÈ-Ì·ÛıÂ› ÁÈ· ÙËÓ ·ÓÙÈÌÂÙÒÈÛ‹ ÙË˜.

AITIO¶A£O°ENEIA§fiÁˆ ÙË˜ ‰˘ÛÎÔÏ›·˜ Ô˘ ··ÓÙ¿Ù·È ÛÙËÓ Î·Ù·ÓfiËÛË ÙÔ˘fiÓÔ˘ ÛÙË ÛÙÔÌ·ÙÔ‰˘Ó›· Î·ıÒ˜ Î·È ÙË˜ ÔÏ˘ÏÔÎfiÙË-Ù·˜ ÙË˜ ÎÏÈÓÈÎ‹˜ ÙË˜ ÂÈÎfiÓ·˜ ÔÏÏÔ› ·Ú¿ÁÔÓÙÂ˜ ¤¯Ô˘ÓÂÌÏ·ÎÂ› ÛÙËÓ ·ÈÙÈÔ·ıÔÁ¤ÓÂÈ· fiˆ˜: ÙÔÈÎ¿ ·›ÙÈ·, Û˘-ÛÙËÌ·ÙÈÎ¿ ·›ÙÈ·, „˘¯ÔÁÂÓ‹ ·›ÙÈ· Î·È ÂÚÈÊÂÚÈÎ¤˜ ‹ ÎÂ-ÓÙÚÈÎ¤˜ ÓÂ˘ÚÔ¿ıÂÈÂ˜8.

TÔÈÎ¿ ·›ÙÈ·™Â ·˘Ù¿ ÂÚÈÏ·Ì‚¿ÓÔÓÙ·È:·) °ÂˆÁÚ·ÊÈÎ‹ ÁÏÒÛÛ·. X·Ú·ÎÙËÚÈÛÙÈÎ‹ ÎÏÈÓÈÎ‹ ÂÈÎfiÓ·ÙË˜ ÁÏÒÛÛ·˜ ÌÂ ÂÚ˘ıÚ¤˜ ÂÚÈÔ¯¤˜ Ô˘ ÂÌÊ·Ó›˙Ô˘Ó ·fi-ÙˆÛË ÙˆÓ ıËÏÒÓ Î·È ÂÚÈ‚¿ÏÏÔÓÙ·È ·fi ÏÂÙ‹ ÏÂ˘Î‹¿Ïˆ. ™ÙËÓ ÏÂÈÔ„ËÊ›· ÙˆÓ ÂÚÈÙÒÛÂˆÓ ‰ÂÓ ÂÌÊ·Ó›˙ÂÈÛ˘ÌÙÒÌ·Ù·, ·ÏÏ¿ Î¿ÔÈÔÈ ·ÛıÂÓÂ›˜ ÌÔÚÂ› Ó· ·ÚÔ˘-ÛÈ¿ÛÔ˘Ó ÛÙÔÌ·ÙÔ‰˘Ó›·9.‚) K·ÓÙÈÓÙ›·ÛË. ™ÙËÓ ÎÏÈÓÈÎ‹ Ú¿ÍË Ë ÌfiÏ˘ÓÛË ·fiCandida Â›Ó·È È‰È·›ÙÂÚ· Û˘¯Ó‹ ¤ÛÙˆ Î·È ¯ˆÚ›˜ ÂÌÊ·Ó‹ÎÏÈÓÈÎ¿ ÛËÌÂ›·1,4,10.Á) °·Ï‚·ÓÈÎ¿ ÚÂ‡Ì·Ù·. ™‡ÌÊˆÓ· ÌÂ ·Ï·ÈfiÙÂÚÂ˜ ÌÂÏ¤-ÙÂ˜11,12 ·ÏÏ¿ Î·È ÌÂ ÙË ÛÙ·‰È·Î‹ ·fiÛ˘ÚÛË ÙÔ˘ ·Ì·ÏÁ¿-Ì·ÙÔ˜ ·fi ÙËÓ Ô‰ÔÓÙÈ·ÙÚÈÎ‹ Ú¿ÍË Ù· ÙÂÏÂ˘Ù·›· ̄ ÚfiÓÈ·,‰ÂÓ ıÂˆÚÂ›Ù·È Ï¤ÔÓ Èı·ÓfiÓ Ë ‰ËÌÈÔ˘ÚÁ›· Á·Ï‚·ÓÈÎÒÓÚÂ˘Ì¿ÙˆÓ ·fi ·Ú·ÎÂ›ÌÂÓÂ˜ ÂÌÊÚ¿ÍÂÈ˜ Ó· Â˘ı‡ÓÂÙ·È ÁÈ·ÙË ÛÙÔÌ·ÙÔ‰˘Ó›·8.‰) AÏÏÂÚÁ›· ÛÂ Ô‰ÔÓÙÈ·ÙÚÈÎ¿ ˘ÏÈÎ¿. K·Ù·ÛÎÂ˘¤˜ Ó¿ÈÏÔÓÔ‰ÔÓÙÔÛÙÔÈ¯ÈÒÓ Î·È ÌÂ›ˆÛË ÙÔ˘ ÌÔÓÔÌÂÚÔ‡˜ Ì¤Ûˆ Â·-Ó·ÔÙ‹ÛÂˆÓ ÙˆÓ Ô‰ÔÓÙÔÛÙÔÈ¯ÈÒÓ ‰ÂÓ ¤‰ˆÛ·Ó ÛËÌ·ÓÙÈ-Î¤˜ ‰È·ÊÔÚ¤˜ ÌÂÙ·Í‡ ·ÛıÂÓÒÓ ÌÂ ÛÙÔÌ·ÙÔ‰˘Ó›·13.

™˘ÛÙËÌ·ÙÈÎ¿ ·›ÙÈ·T· Î˘ÚÈfiÙÂÚ· Û˘ÛÙËÌ·ÙÈÎ¿ ÓÔÛ‹Ì·Ù· Ô˘ ÌÔÚÂ› Ó· ÂÌ-Ê·Ó›ÛÔ˘Ó ÛÙÔÌ·ÙÔ‰˘Ó›· Â›Ó·È:·) AÓ·ÈÌ›Â˜, fiˆ˜ i) ÌÂÁ·ÏÔ‚Ï·ÛÙÈÎ‹ ·fi ¤ÏÏÂÈ„Ë ‚ÈÙ·-Ì›ÓË˜ B12 ‹ Ê˘ÏÏÈÎÔ‡ ÔÍ¤Ô˜14,15 Î·È ii) ÛÈ‰ËÚÔÂÓÈÎ‹. ™ÙÈ˜·Ó·ÈÌ›Â˜ ·˘Ù¤˜, Ë ÛÙÔÌ·ÙÔ‰˘Ó›· Û˘Ó˘¿Ú¯ÂÈ ÌÂ ÎÏÈÓÈÎ¿ÛËÌÂ›· ·fi ÙÔ ÛÙÔÌ·ÙÈÎfi ‚ÏÂÓÓÔÁfiÓÔ, Î˘Ú›ˆ˜ ÁÏˆÛÛ›ÙÈ-

‰· ÌÂ ·fiÙˆÛË ÙˆÓ ÙÚÈ¯ÔÂÈ‰ÒÓ ıËÏÒÓ.‚) EÏÏÂ›„ÂÈ˜ ‚ÈÙ·ÌÈÓÒÓ ÙÔ˘ Û˘ÌÏ¤ÁÌ·ÙÔ˜ B fiˆ˜ B1,B2, B6

16,17, „Â˘‰·ÚÁ‡ÚÔ˘18 Î·È ¿ÏÏˆÓ ÛÙÔÈ¯Â›ˆÓ ¤¯Ô˘Ó ·Ó·-ÊÂÚıÂ› fiÙÈ Û¯ÂÙ›˙ÔÓÙ·È ÌÂ ÙËÓ ÚfiÎÏËÛË ÛÙÔÌ·ÙÔ‰˘Ó›·˜¯ˆÚ›˜ fiÌˆ˜ Ó· ˘¿Ú¯ÂÈ Â·ÚÎ‹˜ ÙÂÎÌËÚ›ˆÛË1.Á) O ‰È·‚‹ÙË˜ Ù‡Ô˘ 2 ÂÓÔ¯ÔÔÈÂ›Ù·È ÁÈ· ÙËÓ ÚfiÎÏËÛËÛÙÔÌ·ÙÔ‰˘Ó›·˜ Ë ÔÔ›· ÔÊÂ›ÏÂÙ·È Â›ÙÂ ÛÙËÓ ÂÚÈÊÂÚÈÎ‹ÓÂ˘ÚÔ¿ıÂÈ· Ô˘ ÚÔÎ·ÏÂ›19 Â›ÙÂ ÛÙËÓ ·Ó¿Ù˘ÍË Î¿ÓÙÈ-ÓÙ·˜ Ô˘ Â˘ÓÔÂ›Ù·È ·fi Ù· ̆ „ËÏ¿ Â›Â‰· Û·Î¯¿ÚÔ˘ Ô˘Û˘¯Ó¿ ·ÓÂ˘Ú›ÛÎÔÓÙ·È ÛÂ ‰È·‚ËÙÈÎÔ‡˜ ·ÛıÂÓÂ›˜20. ¶·Ú¿ÙË Û˘¯Ó‹ ·ÓÂ‡ÚÂÛË ̆ „ËÏÒÓ ÂÈ¤‰ˆÓ Û·Î¯¿ÚÔ˘ ÛÂ ·ÛıÂ-ÓÂ›˜ ÌÂ ÛÙÔÌ·ÙÔ‰˘Ó›·, Ë Û¯¤ÛË ÙÔ˘ ‰È·‚‹ÙË ÌÂ ÙË ÛÙÔ-Ì·ÙÔ‰˘Ó›· ‰ÂÓ Î·Ù·ÁÚ¿ÊÂÙ·È ˆ˜ ÈÎ·Ó‹ Î·È ·Ó·ÁÎ·›·21.‰) A˘ÙÔ¿ÓÔÛ· ÓÔÛ‹Ì·Ù· Ô˘ ÌÔÚÂ› Ó· ÂÌÊ·Ó›ÛÔ˘Ó Î·˘-Û·ÏÁ›· ÛÙÔ ‚ÏÂÓÓÔÁfiÓÔ ÙÔ˘ ÛÙfiÌ·ÙÔ˜ Â›Ó·È i) Ë Î·ÎÔ‹-ıË˜ ÌÂÁ·ÏÔ‚Ï·ÛÙÈÎ‹ ·Ó·ÈÌ›· (Pernicious anemia) Ô˘ÔÊÂ›ÏÂÙ·È ÛÂ Á·ÛÙÚÈÎ‹ ·ÓÂ¿ÚÎÂÈ· ·Ú·ÁˆÁ‹˜ ÙÔ˘ ÂÓ-‰ÔÁÂÓÔ‡˜ ·Ú¿ÁÔÓÙ· Ô˘ ··ÈÙÂ›Ù·È ÁÈ· ÙËÓ ·ÔÚÚfi-ÊËÛË ÙË˜ ‚ÈÙ·Ì›ÓË˜ B12

22,23 ii) ÙÔ Û‡Ó‰ÚÔÌÔ Sjögren, iii) ËÚÂ˘Ì·ÙÔÂÈ‰‹˜ ·ÚıÚ›ÙÈ‰·, iv) Ë È‰ÈÔ·ı‹˜ ıÚÔÌ‚ÔÎ˘ÙÔ-ÂÓ›· Î·È v) Ô ˘Ôı˘ÚÂÔÂÈ‰ÈÛÌfi˜24.Â) OÈ ÔÚÌÔÓÈÎ¤˜ ÌÂÙ·‚ÔÏ¤˜ Ô˘ ·Ú·ÙËÚÔ‡ÓÙ·È Î·Ù¿ ÙËÓÂÌÌËÓfi·˘ÛË ¤¯Ô˘Ó ıÂˆÚËıÂ› ÛËÌ·ÓÙÈÎÔ› ·Ú¿ÁÔÓÙÂ˜ÛÙËÓ ·ÈÙÈÔ·ıÔÁ¤ÓÂÈ· ÙË˜ ÛÙÔÌ·ÙÔ‰˘Ó›·˜1. YÔÏÔÁ›˙ÂÙ·ÈfiÙÈ ÙÔ 90% ÙˆÓ Á˘Ó·ÈÎÒÓ ÌÂ ÌÂÙÂÌÌËÓÔ·˘ÛÈ·Î¿ Û˘-ÌÙÒÌ·Ù· ÂÌÊ·Ó›˙ÂÈ ÛÙÔÌ·ÙÔ‰˘Ó›· 3-12 ¤ÙË ÌÂÙ¿ ÙËÓ ÂÌ-ÌËÓfi·˘ÛË4. ¶·Ú¿ ÙËÓ ÌÂÁ¿ÏË Û˘¯ÓfiÙËÙ· ÂÌÊ¿ÓÈÛË˜ÛÙÔÌ·ÙÔ‰˘Ó›·˜ ÛÂ ÂÌÌËÓÔ·˘ÛÈ·Î¤˜ Á˘Ó·›ÎÂ˜, Ë ¯ÔÚ‹-ÁËÛË ÔÚÌÔÓÒÓ ‰ÂÓ ¤¯ÂÈ ‰ÒÛÂÈ Ù· ÚÔÛ‰ÔÎÒÌÂÓ· ·ÔÙÂ-Ï¤ÛÌ·Ù·25.

æ˘¯ÔÁÂÓÂ›˜ ·Ú¿ÁÔÓÙÂ˜ H ÛÙÔÌ·ÙÔ‰˘Ó›· ¤¯ÂÈ Û˘Ó‰ÂıÂ› ÌÂ „˘¯ÔÏÔÁÈÎ¤˜ ‰È·Ù·-Ú·¯¤˜, Î˘Ú›ˆ˜ ¿Á¯Ô˜ Î·È ·ÓÙÈ‰Ú·ÛÙÈÎ‹ Î·Ù¿ıÏÈ„Ë fiˆ˜¤¯ÂÈ ·Ô‰ÂÈ¯ıÂ› ·fi ¤ÚÂ˘ÓÂ˜ ÌÂ ÎÏÈÓÈÎ¤˜ Û˘ÓÂÓÙÂ‡ÍÂÈ˜Î·È „˘¯ÔÏÔÁÈÎ¿ ÂÚˆÙËÌ·ÙÔÏfiÁÈ·26,27. H ÛÙÔÌ·ÙÔ‰˘Ó›· Â-ÚÈÁÚ¿ÊÂÙ·È Â›ÛË˜ Î·È ˆ˜ Ì›· „˘¯ÔÛˆÌ·ÙÈÎ‹ ‰È·Ù·Ú·¯‹Ô˘ ˘ÚÔ‰ÔÙÂ›Ù·È Û˘Ó‹ıˆ˜ ·fi ‰˘Û¿ÚÂÛÙÂ˜ Â·ÁÁÂÏ-Ì·ÙÈÎ¤˜ ‹ ÔÈÎÔÁÂÓÂÈ·Î¤˜ Î·Ù·ÛÙ¿ÛÂÈ˜28. MÂÙ·Í‡ ÙˆÓ ·ÛıÂ-ÓÒÓ ÌÂ ÛÙÔÌ·ÙÔ‰˘Ó›· ·Ó·Ê¤ÚÂÙ·È ÈÎ·Ófi˜ ·ÚÈıÌfi˜ ·Ùfi-ÌˆÓ ÌÂ ‰È·Ù·Ú·¯¤˜ ÚÔÛˆÈÎfiÙËÙ·˜29.

•ËÚÔÛÙÔÌ›·Ÿˆ˜ Â›Ó·È ÁÓˆÛÙfi ·fi ÙÔ˘˜ ·ÛıÂÓÂ›˜ ÌÂ Û‡Ó‰ÚÔÌÔSjögren, Ë ÍËÚÔÛÙÔÌ›· ÌÔÚÂ› Ó· ·ÔÙÂÏÂ› ·ÈÙ›· ÛÙÔÌ·-ÙÔ‰˘Ó›·˜ Â›ÙÂ ·˘Ù‹ ÂÚÈÁÚ¿ÊÂÙ·È ˆ˜ Î·˘Û·ÏÁ›· Â›ÙÂ ˆ˜Ì›· ÔÏ‡ ‰˘Û¿ÚÂÛÙË ·›ÛıËÛË fiÓÔ˘ ÛÙÔ ÛÙÔÌ·ÙÈÎfi ‚ÏÂÓ-ÓÔÁfiÓÔ4. M¤¯ÚÈ Û‹ÌÂÚ· ÔÈ ÂÚÂ˘ÓËÙ¤˜ ‰ÂÓ ¤¯Ô˘Ó ÂÓÙÔ›-ÛÂÈ Û˘ÁÎÂÎÚÈÌ¤ÓÂ˜ ‰È·ÊÔÚ¤˜ ÛÙËÓ Û‡ÛÙ·ÛË Î·È ÔÛfiÙË-Ù· ÙÔ˘ Û¿ÏÈÔ˘ ÙˆÓ ·ÛıÂÓÒÓ ÌÂ ÛÙÔÌ·ÙÔ‰˘Ó›·30. ¢È·ÊÔ-Ú¤˜ Ô˘ ¤¯Ô˘Ó ‰È·ÈÛÙˆıÂ› ÛÙÔ Û¿ÏÈÔ ·ÛıÂÓÒÓ ÌÂ ÛÙÔ-Ì·ÙÔ‰˘Ó›·, fiˆ˜ ÛÙËÓ ÔÛfiÙËÙ· IgA, ÛÙÔ pH Î·È ÛÙËÓËÏÂÎÙÚÈÎ‹ ·ÁˆÁÈÌfiÙËÙ·, ‰ÂÓ Â›Ó·È ·ıÔÁÓˆÌÔÓÈÎ¤˜31 Î·ÈË Û˘Û¯¤ÙÈÛ‹ ÙÔ˘˜ ÌÂ ÙË ÛÙÔÌ·ÙÔ‰˘Ó›· ‰ÂÓ ¤¯ÂÈ Â·ÚÎÒ˜‰ÈÂ˘ÎÚÈÓÈÛıÂ›1.

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°Â˘ÛÙÈÎ¤˜ ‰˘ÛÏÂÈÙÔ˘ÚÁ›Â˜ H ÂÌÏÔÎ‹ ÙË˜ ÁÂ˘ÛÙÈÎ‹˜ ÈÎ·ÓfiÙËÙ·˜ ÛÙË ÛÙÔÌ·ÙÔ‰˘Ó›·¤¯ÂÈ ÛËÌÂÈˆıÂ› ·fi ÂÚÂ˘ÓËÙ¤˜ Ô˘ ¤¯Ô˘Ó ‰È·ÈÛÙÒÛÂÈÙËÓ ‡·ÚÍË ÈÎ·ÓÔ‡ ·ÚÈıÌÔ‡ ·ÙfiÌˆÓ ÌÂ ÂÍ·ÈÚÂÙÈÎ¿ ·Ó·-Ù˘ÁÌ¤ÓË ÁÂ˘ÛÙÈÎ‹ ÈÎ·ÓfiÙËÙ· (supertasters) ÌÂÙ·Í‡ ÙˆÓ·ÛıÂÓÒÓ ÌÂ ÛÙÔÌ·ÙÔ‰˘Ó›·32. OÈ ·ÛıÂÓÂ›˜ ·˘ÙÔ› ¤¯Ô˘Ó ÌÂ-Á¿ÏË Èı·ÓfiÙËÙ· ÂÌÊ¿ÓÈÛË˜ ÛÙÔÌ·ÙÔ‰˘Ó›·˜, ÂÍ·ÈÙ›·˜ ÙË˜ÌÂÁ¿ÏË˜ ˘ÎÓfiÙËÙ·˜ ÁÂ˘ÛÙÈÎÒÓ Î·Ï‡ÎˆÓ Ô˘ Ê¤ÚÔ˘Ó.OÈ ÁÂ˘ÛÙÈÎÔ› ·˘ÙÔ› Î¿Ï˘ÎÂ˜ ÂÚÈ‚¿ÏÏÔÓÙ·È ·fi ÓÂ˘ÚÒ-ÓÂ˜ ÙÔ˘ ÙÚ›‰˘ÌÔ˘ ÓÂ‡ÚÔ˘ Ô˘ ‰È·‚È‚¿˙Ô˘Ó ÙÔÓ fiÓÔ (VÎÚ·ÓÈ·Îfi ÓÂ‡ÚÔ)33. ÕÏÏÔÈ ÂÚÂ˘ÓËÙ¤˜ ¤¯Ô˘Ó ‰È·ÈÛÙÒÛÂÈfiÙÈ Ë ÈÎ·ÓfiÙËÙ· Ó· ·Ó·ÁÓˆÚ›˙ÂÙ·È Ë ÈÎÚ‹ ÁÂ‡ÛË ÌÂÈÒ-ÓÂÙ·È Î·Ù¿ ÙËÓ ÂÌÌËÓfi·˘ÛË34. H ¤ÎÙˆÛË ÛÙËÓ ÈÎ·Ófi-ÙËÙ· ·Ó·ÁÓÒÚÈÛË˜ ÙË˜ ÈÎÚ‹˜ ÁÂ‡ÛË˜ ·fi ÙË ̄ ÔÚ‰‹ ÙÔ˘Ù˘Ì¿ÓÔ˘ ÙÔ˘ ÚÔÛˆÈÎÔ‡ ÓÂ‡ÚÔ˘ (VII ÎÚ·ÓÈ·Îfi ÓÂ‡ÚÔ)¤¯ÂÈ Û·Ó ·ÔÙ¤ÏÂÛÌ· ÙËÓ ÂÓ›Û¯˘ÛË ÙË˜ ·›ÛıËÛË˜ ÙË˜ ÁÂ‡-ÛË˜ ·fi ÙÈ˜ ÂÚÈÔ¯¤˜ Ô˘ ÓÂ˘ÚÒÓÔÓÙ·È ·fi ÙÔ ÁÏˆÛÛÔ-Ê·Ú˘ÁÁÈÎfi ÓÂ‡ÚÔ (IX ÎÚ·ÓÈ·Îfi ÓÂ‡ÚÔ) Î·È ÙË ‰ËÌÈÔ˘ÚÁ›·ÁÂ˘ÛÙÈÎÒÓ Ê·ÓÙ·ÛÌ¿ÙˆÓ35. Œ¯ÂÈ Â›ÛË˜ ̆ ÔÛÙËÚÈ¯ıÂ› fiÙÈË ‰È·Ù·Ú·¯‹ ÙË˜ ÁÂ‡ÛË˜ ÌÔÚÂ› Ó· Û¯ÂÙ›˙ÂÙ·È ÌÂ ÙËÓ ·Ò-ÏÂÈ· ÎÂÓÙÚÈÎ‹˜ ·Ó·ÛÙÔÏ‹˜ ÙË˜ ÌÂÙ·ÊÔÚ¿˜ ÂÚÂıÈÛÌ¿ÙˆÓÌ¤Ûˆ ÓÂ˘ÚÈÎÒÓ ÈÓÒÓ ÙÔ˘ ÙÚ›‰˘ÌÔ˘ ÓÂ‡ÚÔ˘ Ô˘ ÌÂÙ·Ê¤-ÚÔ˘Ó ÙÔÓ fiÓÔ Î·È ·˘Ùfi ÌÔÚÂ› Ó· Ô‰ËÁÂ› ÛÙ· Û˘ÌÙÒ-Ì·Ù· ÙË˜ Î·˘Û·ÏÁ›·˜ ÙÔ˘ ÛÙfiÌ·ÙÔ˜32.

§ÔÈ¿ Èı·Ó¿ ·›ÙÈ·K·Ù¿ Î·ÈÚÔ‡˜, Ë ÛÙÔÌ·ÙÔ‰˘Ó›· ¤¯ÂÈ Û˘Ó‰ÂıÂ› ÌÂ ÙË Ï‹-„Ë ‰È·ÊfiÚˆÓ Ê·ÚÌ·ÎÂ˘ÙÈÎÒÓ Ô˘ÛÈÒÓ. H ÈÔ ÚfiÛÊ·ÙË·Ó·ÊÔÚ¿ Û˘Ó‰¤ÂÈ ÙË Ï‹„Ë ·Ó·ÛÙÔÏ¤ˆÓ ÙÔ˘ ÌÂÙ·ÙÚÂÙÈ-ÎÔ‡ ÂÓ˙‡ÌÔ˘ ÙË˜ ·ÁÁÂÈÔÙ·Û›ÓË˜ (·-MEA), Ô˘ ¯ÔÚËÁÔ‡-Ó·È ÁÈ· ÙËÓ ˘¤ÚÙ·ÛË, ÌÂ ÙËÓ ÂÌÊ¿ÓÈÛË Î·˘Û·ÏÁ›·˜ ÛÙÔÛÙÔÌ·ÙÈÎfi ‚ÏÂÓÓÔÁfiÓÔ, Ë ÔÔ›· ÌÂÙ¿ ·fi ÌÂ›ˆÛË ‹ ‰È·-ÎÔ‹ ÙˆÓ Û˘ÁÎÂÎÚÈÌ¤ÓˆÓ Ê·ÚÌ·ÎÂ˘ÙÈÎÒÓ Ô˘ÛÈÒÓ ˘Ô-¯ˆÚÂ› Ì¤Û· ÛÂ Ï›ÁÂ˜ Â‚‰ÔÌ¿‰Â˜36,37. EÓ‰È·Ê¤ÚÔÓ Â›Ó·È Â›-ÛË˜ ÙÔ ÁÂÁÔÓfi˜ fiÙÈ Ë Û˘ÁÎÂÎÚÈÌ¤ÓË Ê·ÚÌ·ÎÂ˘ÙÈÎ‹ Ô˘Û›·¤¯ÂÈ ÂÓÔ¯ÔÔÈËıÂ› Î·È ÁÈ· ·ÒÏÂÈ· ÙË˜ ÁÂ‡ÛË˜36.

ANTIMETø¶I™HH ·ÓÙÈÌÂÙÒÈÛË ÂÚÈÏ·Ì‚¿ÓÂÈ Ù· ·Ú·Î¿Ùˆ ÛÙ¿‰È·:·) §‹„Ë ÂÓfi˜ ÏÂÙÔÌÂÚÔ‡˜ ÈÛÙÔÚÈÎÔ‡. OÈ ·ÛıÂÓÂ›˜ ÌÂÛÙÔÌ·ÙÔ‰˘Ó›· Â›Ó·È Û˘Ó‹ıˆ˜ Ù·Ï·ÈˆÚËÌ¤ÓÔÈ ·fi ÙËÓ·Ú·ÔÌ‹ ÙÔ˘˜ ÛÂ È·ÙÚÔ‡˜ ‰È·ÊfiÚˆÓ ÂÈ‰ÈÎÔÙ‹ÙˆÓ Î·ÈÂ›Ó·È ÂÍ·ÈÚÂÙÈÎ¿ ÛËÌ·ÓÙÈÎfi Ó· ·Ó·Ù˘¯ıÂ› ÂÌÈÛÙÔÛ‡ÓËÌÂÙ·Í‡ ·ÛıÂÓÔ‡˜ Î·È ıÂÚ¿ÔÓÙÔ˜.‚) §ÂÙÔÌÂÚ‹˜ ÂÈÛÎfiËÛË ÙÔ˘ ÛÙÔÌ·ÙÈÎÔ‡ ‚ÏÂÓÓÔÁfi-ÓÔ˘ ÒÛÙÂ Ó· ‰È·ÈÛÙˆıÔ‡Ó Ù˘¯fiÓ ·ıÔÏÔÁÈÎ¤˜ ÂÍÂÚÁ·-Û›Â˜.Á) ¢ÈÂÓ¤ÚÁÂÈ· ·ÈÌ·ÙÔÏÔÁÈÎÒÓ Î·È ‚ÈÔ¯ËÌÈÎÒÓ ÂÍÂÙ¿ÛÂˆÓ.H ·ÈÌ·ÙÔÏÔÁÈÎ‹ Î·È ‚ÈÔ¯ËÌÈÎ‹ ‰ÈÂÚÂ‡ÓËÛË Ú¤ÂÈ Ó· Â-ÚÈÏ·Ì‚¿ÓÂÈ:i) °ÂÓÈÎ‹ ·›Ì·ÙÔ˜, Û›‰ËÚÔ ÔÚÔ‡ Î·È ÊÂÚÚÈÙ›ÓË ÒÛÙÂ Ó·ÂÏÂÁ¯ıÂ› Ë ‡·ÚÍË ·Ó·ÈÌÈÒÓ. ii) M¤ÙÚËÛË ÙÔ˘ Û·Î¯¿ÚÔ˘ ÙÔ˘ ·›Ì·ÙÔ˜ ÁÈ· Ó· ‰È·ÈÛÙˆıÂ›‹ ·ÔÎÏÂÈÛıÂ› Ë ‡·ÚÍË ‰È·‚‹ÙË ÛÙÔÓ ·ÛıÂÓ‹, Ô˘ ¤¯ÂÈ

Û˘Û¯ÂÙÈÛÙÂ› ÌÂ ÙËÓ ÛÙÔÌ·ÙÔ‰˘Ó›· ·fi ÔÏÏÔ‡˜ ÎÏÈÓÈÎÔ‡˜Î·È ÂÚÂ˘ÓËÙ¤˜.iii) ŒÏÂÁ¯Ô˜ T3, T4, TSH ÒÛÙÂ Ó· ·ÔÎÏÂÈÛıÂ› ÔÔÈ·‰‹-ÔÙÂ ‰˘ÛÏÂÈÙÔ˘ÚÁ›· ÙÔ˘ ı˘ÚÂÔÂÈ‰Ô‡˜ ·‰¤Ó·, Î·ıfiÙÈ Ô˘Ôı˘ÚÂÔÂÈ‰ÈÛÌfi˜ ÂÓÔ¯ÔÔÈÂ›Ù·È ÁÈ· ÙËÓ ÚfiÎÏËÛË ÛÙÔ-Ì·ÙÔ‰˘Ó›·˜. iv) ŒÏÂÁ¯Ô˜ ÙÔ˘ ÚÂ˘Ì·ÙÔÂÈ‰Ô‡˜ ·Ú¿ÁÔÓÙ· Î·ıfiÙÈ Ù˘-¯fiÓ ·‡ÍËÛ‹ ÙÔ˘ Èı·ÓÒ˜ Ó· ˘Ô‰ÂÈÎÓ‡ÂÈ ÙËÓ ‡·ÚÍË Î¿-ÔÈÔ˘ ·˘ÙÔ¿ÓÔÛÔ˘ ÓÔÛ‹Ì·ÙÔ˜ Ô˘ ÂÚÈÏ·Ì‚¿ÓÂÙ·È ÛÙËÓ·ÈÙÈÔÏÔÁ›· ÙË˜ ÛÙÔÌ·ÙÔ‰˘Ó›·˜ fiˆ˜ Â›Ó·È Ë ÚÂ˘Ì·ÙÔÂÈ-‰‹˜ ·ÚıÚ›ÙÈ‰· Î·È ÙÔ Û‡Ó‰ÚÔÌÔ Sjögren.H ·ÓÂ‡ÚÂÛË ÔÔÈ·Û‰‹ÔÙÂ ÌË Ê˘ÛÈÔÏÔÁÈÎ‹˜ ÙÈÌ‹˜ ÛÙÈ˜·Ú·¿Óˆ ÂÍÂÙ¿ÛÂÈ˜ Â›Ó·È ‰˘ÓËÙÈÎ¿ ·ÈÙ›· ÙË˜ ÛÙÔÌ·ÙÔ-‰˘Ó›·˜ Î·È Ú¤ÂÈ Ó· Á›ÓÂÈ ·Ú·ÔÌ‹ ÙÔ˘ ·ÛıÂÓÔ‡˜ ÛÙÔÓ·ÓÙ›ÛÙÔÈ¯Ô ÂÈ‰ÈÎfi È·ÙÚfi ÁÈ· Ó· ‰ÈÂÚÂ˘ÓËıÂ› Û˘ÓÔÏÈÎ¿ Î·ÈÓ· ÙÔ˘ ¯ÔÚËÁËıÂ› Ë Î·Ù¿ÏÏËÏË ıÂÚ·Â›·.™ÙËÓ ÂÚ›ÙˆÛË Ô˘ ‰ÂÓ ·ÓÂ˘ÚÂıÂ› ˘ÔÎÂ›ÌÂÓË ·ıÔ-ÏÔÁÈÎ‹ Î·Ù¿ÛÙ·ÛË ÔÊÂ›ÏÂÈ Ô ıÂÚ¿ˆÓ È·ÙÚfi˜ Ó· ÂÍËÁ‹-ÛÂÈ ÙËÓ ÔÏ˘ÏÔÎfiÙËÙ· ÙÔ˘ Û˘ÁÎÂÎÚÈÌ¤ÓÔ˘ ÚÔ‚Ï‹Ì·-ÙÔ˜ Î·ıÒ˜ Î·È ÙËÓ ‰˘ÛÎÔÏ›· ·ÓÙÈÌÂÙÒÈÛ‹˜ ÙÔ˘ ÛÙÔÓ·ÛıÂÓ‹ Î·È Ó· ÚÔÙÂ›ÓÂÈ Ó· ‰ÔÎÈÌ·ÛıÔ‡Ó ‰È¿ÊÔÚÂ˜ Ê·Ú-Ì·ÎÂ˘ÙÈÎ¤˜ ·ÁˆÁ¤˜ ·Ó¿ÏÔÁ· ÌÂ ÙËÓ ¤ÓÙ·ÛË ÙˆÓ Û˘-ÌÙˆÌ¿ÙˆÓ, ÙËÓ ÂÈı˘Ì›· Î·È ÙËÓ Û˘ÓÂÚÁ·Û›· ÙÔ˘ ·ÛıÂ-ÓÔ‡˜.

ºAPMAKEYTIKH A°ø°HTÔÈÎ‹·) ™ÙÔÌ·ÙÈÎ¤˜ Ï‡ÛÂÈ˜ ÌÂ ÛÔ‰fiÓÂÚÔ ‹ ¯·ÌÔÌ‹ÏÈ. AÚÎÂ-ÙÔ› ·ÛıÂÓÂ›˜ Ê·›ÓÂÙ·È fiÙÈ ·Ô‰¤¯ÔÓÙ·È Â˘ÎÔÏfiÙÂÚ· ÙÔÚfi‚ÏËÌ· ÙË˜ ÛÙÔÌ·ÙÔ‰˘Ó›·˜ ÌÂÙ¿ ÙËÓ ‰ÈÂÓ¤ÚÁÂÈ· Ï‹-ÚÔ˘˜ ·ÈÌ·ÙÔÏÔÁÈÎÔ‡ Î·È ‚ÈÔ¯ËÌÈÎÔ‡ ÂÏ¤Á¯Ô˘ ÁÈ· ÙËÓ ‰ÈÂ-ÚÂ‡ÓËÛË Ù˘¯fiÓ ̆ ÔÎÂ›ÌÂÓË˜ ·ıÔÏÔÁÈÎ‹˜ ·ÈÙ›·˜ Î·È ·Ó·-Ê¤ÚÔ˘Ó ·Ó·ÎÔ‡ÊÈÛË ·fi ÙÔÓ Î·‡ÛÔ ÛÙÔ ÛÙÔÌ·ÙÈÎfi ‚ÏÂÓ-ÓÔÁfiÓÔ ÌÂÙ¿ ·fi ÛÙÔÌ·ÙÈÎ¤˜ Ï‡ÛÂÈ˜, ÔÈ ÔÔ›Â˜ Èı·ÓÒ˜Ó· ÏÂÈÙÔ˘ÚÁÔ‡Ó Î·È ·ÔÎÏÂÈÛÙÈÎ¿ ˆ˜ placebo.‚) ™ÙÔÌ·ÙÈÎ¤˜ Ï‡ÛÂÈ˜ ÌÂ ‰È¿Ï˘Ì· Î·„·˚Î›ÓË˜ 1:2 ÛÂ ÓÂ-Úfi. TÔ ‰È¿Ï˘Ì· ÙË˜ Î·„·˚Î›ÓË˜ ÛÙÔ ÓÂÚfi ÌÔÚÂ› Ó· Êı¿-ÛÂÈ ÛÂ ·Ó·ÏÔÁ›· 1:1 ·Ó ·˘Ùfi Â›Ó·È ·ÓÂÎÙfi ·fi ÙÔÓ·ÛıÂÓ‹8. H Î·„·˚Î›ÓË Â›Ó·È Ë ‰Ú·ÛÙÈÎ‹ Ô˘Û›· ÙË˜ ÍÂÚ‹˜ÎfiÎÎÈÓË˜ ÈÂÚÈ¿˜ Ô˘ ‰Ú· Î·Ù¿ ÂÍÂÈ‰ÈÎÂ˘Ì¤ÓÔ ÙÚfiÔÛÙÔ˘˜ ÓÂ˘ÚÒÓÂ˜ ·ÓÙÈ‰ÚÒÓÙ·˜ ÌÂ ÙÈ˜ ÚˆÙÂ›ÓÂ˜ ÙˆÓ ÌÂÌ-‚Ú·ÓÒÓ ÙÔ˘˜. MÂ ÙÔÓ ÙÚfiÔ ·˘Ùfi ÂËÚÂ¿˙ÂÈ ÙË ÏÂÈÙÔ˘Ú-Á›· ÙˆÓ ‰È·‡ÏˆÓ ÈfiÓÙˆÓ ÒÛÙÂ ÔÈ ÓÂ˘ÚÒÓÂ˜ Ó· ‰ËÌÈÔ˘Ú-ÁÔ‡Ó Î·È Ó· ÌÂÙ·‰›‰Ô˘Ó «Ï·Óı·ÛÌ¤Ó· Û‹Ì·Ù·» ÚÔ˜ ÙÔÓÂÁÎ¤Ê·ÏÔ. H ·›ÛıËÛË Î·„›Ì·ÙÔ˜ ·fi ÙËÓ Î·„·˚Î›ÓË ÚÔ-¤Ú¯ÂÙ·È ·fi ÙÔÓ ÂÚÂıÈÛÌfi ·ÈÛıËÙËÚ›ˆÓ ÓÂ˘ÚÒÓˆÓ ÙÔ˘fiÓÔ˘, ÙˆÓ ÙÚ›‰˘ÌˆÓ Î˘ÙÙ¿ÚˆÓ, Ô˘ ·ÂÏÂ˘ıÂÚÒÓÔ˘Ó¤Ó· ÓÂ˘ÚÔÂÙ›‰ÈÔ ÙÔ ÔÔ›Ô ÏËÚÔÊÔÚÂ› ÙÔÓ ÂÁÎ¤Ê·ÏÔÁÈ· ÙËÓ ‡·ÚÍË fiÓÔ˘ ‹ ÂÚÂıÈÛÌÔ‡ ÛÙÔ ‰¤ÚÌ· ‹ ÛÙÔ‚ÏÂÓÓÔÁfiÓÔ ÙÔ˘ ÛÙfiÌ·ÙÔ˜. H Â·Ó·Ï·Ì‚·ÓfiÌÂÓË Ï‹„ËÎ·„·˚Î›ÓË˜ ¤¯ÂÈ ˆ˜ ·ÔÙ¤ÏÂÛÌ· ÙË ÌÂ›ˆÛË ÙÔ˘ ÓÂ˘ÚÔ-ÂÙÈ‰›Ô˘ ·˘ÙÔ‡ ÛÙÔ˘˜ ÓÂ˘ÚÒÓÂ˜ ÔfiÙÂ ·Ú¯›˙ÂÈ Ó· ‰Ë-ÌÈÔ˘ÚÁÂ›Ù·È ·ÓÔ¯‹ Î·È ·ÓÙÔ¯‹ ÛÙÔÓ Î·‡ÛÔ ÙÔ˘ ‚ÏÂÓÓÔ-ÁfiÓÔ˘ ÙÔ˘ ÛÙfiÌ·ÙÔ˜38. H Î·„·˚Î›ÓË Ê·›ÓÂÙ·È fiÙÈ ·ÚÔ˘-

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ÛÈ¿˙ÂÈ ‰‡Ô ·ÏÏËÏÔÛ˘ÁÎÚÔ˘fiÌÂÓÂ˜ È‰ÈfiÙËÙÂ˜: ·fi ÙË Ì›·ÚÔÎ·ÏÂ› ÈÛ¯˘Úfi Î·˘ÛÙÈÎfi fiÓÔ, ÂÚÂıÈÛÌfi Î·È ÊÏfiÁˆ-ÛË Û‡ÓÙÔÌË˜ ‰È¿ÚÎÂÈ·˜ Î·È ÛÙËÓ Û˘Ó¤¯ÂÈ· ·ÚÔ˘ÛÈ¿˙ÂÈ·Ó·ÏÁËÙÈÎ¤˜ Î·È ·ÓÙÈÂÚÂıÈÛÙÈÎ¤˜ È‰ÈfiÙËÙÂ˜ Ì·ÎÚ¿˜ ‰È¿Ú-ÎÂÈ·˜39.

™˘ÛÙËÌ·ÙÈÎ‹·) §ÈÔ˚Îfi ÔÍ‡. TÔ ÏÈÔ˚Îfi ÔÍ‡ Â›Ó·È ·ÓÙÈÔÍÂÈ‰ˆÙÈÎ‹ Ô˘-Û›· Ô˘ ‰È·ÂÚÓ¿ ÙËÓ Î˘ÙÙ·ÚÈÎ‹ ÌÂÌ‚Ú¿ÓË Î·ıfiÙÈ Â›Ó·È‰È·Ï˘Ùfi Î·È ÛÙÔ Ï›Ô˜ Î·È ÛÙÔ ÓÂÚfi. ¢ÂÓ Â›Ó·È Ù˘ÈÎ‹ Ê·Ú-Ì·ÎÂ˘ÙÈÎ‹ Ô˘Û›· ·ÏÏ¿ Û˘ÌÏ‹ÚˆÌ· ‰È·ÙÚÔÊ‹˜. Œ¯ÂÈ ‰Ô-ÎÈÌ·ÛıÂ› ÛÂ ‰È¿ÊÔÚÂ˜ ·ı‹ÛÂÈ˜ fiˆ˜ ÛÂ Î·Ú‰È·Î¤˜ Ófi-ÛÔ˘˜, ·ıËÚÔÛÎÏ‹ÚˆÛË, ÔÏÏ·Ï‹ ÛÎÏ‹Ú˘ÓÛË, ÔÏ˘-ÓÂ˘ÚÔ¿ıÂÈÂ˜ Î·È Ë·ÙÈÎ¤˜ ÓfiÛÔ˘˜40. K¿ÔÈÔÈ ÂÚÂ˘ÓËÙ¤˜Î·Ù¤ÁÚ·„·Ó ÛËÌ·ÓÙÈÎ‹ ‚ÂÏÙ›ˆÛË ÙË˜ ÛÙÔÌ·ÙÔ‰˘Ó›·˜ ÛÂ·ÛıÂÓÂ›˜ ÌÂ ÂÏÂ‡ıÂÚÔ È·ÙÚÈÎfi ÈÛÙÔÚÈÎfi ÌÂÙ¿ ·fi ‰‡Ô ÌË-ÓÒÓ ¯ÔÚ‹ÁËÛË41.‚) TÚÈÎ˘ÎÏÈÎ¿ ·ÓÙÈÎ·Ù·ıÏÈÙÈÎ¿. H ¯ÔÚ‹ÁËÛË ·ÓÙÈÎ·Ù·-ıÏÈÙÈÎÒÓ ¤¯ÂÈ ‰ÒÛÂÈ ÔÏ‡ Î·Ï¿ ·ÔÙÂÏ¤ÛÌ·Ù· ÛÙË ÛÙÔ-Ì·ÙÔ‰˘Ó›· ¤ÙÛÈ ÒÛÙÂ ·fi ·ÚÎÂÙÔ‡˜ Ó· ıÂˆÚÂ›Ù·È Ê¿Ú-Ì·ÎÔ ÂÈÏÔÁ‹˜42. XÔÚËÁÔ‡ÓÙ·È Û˘Ó‹ıˆ˜ 10 ¤ˆ˜ 150 mg·ÌÈÙÚÈÙ˘Ï›ÓË ‹ ÓÔÚÙÚÈÙÈÏ›ÓË ËÌÂÚËÛ›ˆ˜ ÍÂÎÈÓÒÓÙ·˜·fi 10 mg ÚÈÓ ·fi ÙËÓ Î·Ù¿ÎÏÈÛË Î·È ·˘Í¿ÓÔÓÙ·˜ 10mg ·Ó¿ 4-7 ËÌ¤ÚÂ˜ Ì¤¯ÚÈ Ó· ÛËÌÂÈˆıÂ› ‚ÂÏÙ›ˆÛË8.Á) BÂÓ˙Ô‰È·˙Â›ÓÂ˜. T· ·ÔÙÂÏ¤ÛÌ·Ù· Ô˘ ¤¯Ô˘Ó ·Ó·-ÊÂÚıÂ› ·fi ÌÂÏ¤ÙÂ˜ Â›Ó·È Â›ÛË˜ ÈÎ·ÓÔÔÈËÙÈÎ¿ ÛÂ ¯·-ÌËÏ‹ ‰ÔÛÔÏÔÁ›·43-4. XÔÚËÁÂ›Ù·È Û˘Ó‹ıˆ˜ Û¯‹Ì· ‰È·˙Â-¿ÌË˜ 0.25-2 mg ËÌÂÚËÛ›ˆ˜ ÍÂÎÈÓÒÓÙ·˜ ·fi 0.25 mgÚÈÓ ·fi ÙËÓ Î·Ù¿ÎÏÈÛË Î·È ·˘Í¿ÓÔÓÙ·˜ ÙË ‰fiÛË ·Ó¿ 4-7 ËÌ¤ÚÂ˜ Ì¤¯ÚÈ Ó· ·Ú·ÙËÚËıÂ› ‚ÂÏÙ›ˆÛË Î·È ÂÊfiÛÔÓ ‰ÂÓ ÛËÌÂÈˆıÔ‡Ó ·ÚÂÓ¤ÚÁÂÈÂ˜8.‰) AÓÙÈÂÈÏËÙÈÎ¿. Œ¯Ô˘Ó ‰ÔÎÈÌ·ÛıÂ› ÌÂ ·ÚÎÂÙ¿ ÈÎ·ÓÔ-ÔÈËÙÈÎ¿ ·ÔÙÂÏ¤ÛÌ·Ù·, ·Ó Î·È ··ÈÙÂ›Ù·È ÌÂÁ¿ÏË ÚÔ-ÛÔ¯‹ ÁÈ· ÙËÓ ·ÔÊ˘Á‹ ·ÚÂÓÂÚÁÂÈÒÓ46. H ‰ÔÛÔÏÔÁ›· Î˘-Ì·›ÓÂÙ·È ·fi 300-1600 mg ÁÎ·Ì·ÂÓÙ›ÓË˜ (.¯.Neurontin) ËÌÂÚËÛ›ˆ˜ ÍÂÎÈÓÒÓÙ·˜ ·fi 100 mg ËÌÂÚË-Û›ˆ˜ Î·È ·˘Í¿ÓÔÓÙ·˜ 100 mg Î¿ıÂ 4-7 ËÌ¤ÚÂ˜. ŸÛÔ ·˘-Í¿ÓÂÙ·È Ë ‰ÔÛÔÏÔÁ›· ÙÔ Ê¿ÚÌ·ÎÔ ¯ÔÚËÁÂ›Ù·È ÛÂ ‰‡Ô ‹ÙÚÂ›˜ ‰fiÛÂÈ˜8. AÍ›˙ÂÈ Ó· ÛËÌÂÈˆıÂ› fiÙÈ Ë Î·Ï‡ÙÂÚË ·ÓÙ·-fiÎÚÈÛË ÙˆÓ ·ÛıÂÓÒÓ ÌÂ ÛÙÔÌ·ÙÔ‰˘Ó›· ÂÈÙ˘Á¯¿ÓÂÙ·ÈÌÂ ÙË ¯·ÌËÏfiÙÂÚË ‰˘Ó·Ù‹ ‰ÔÛÔÏÔÁ›·8.

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Â˘ÎÚ›ÓÈÛÙË Î·È Ë ·ÓÙÈÌÂÙÒÈÛ‹ ÙË˜ Â›Ó·È Û˘¯Ó¿ ‰˘-Û¯ÂÚ‹˜ Î·È ¯ÚÔÓÔ‚fiÚ·. A·ÈÙÂ› ÙË Ï‹„Ë ÂÓfi˜ ÏÂÙÔ-ÌÂÚÔ‡˜ ÈÛÙÔÚÈÎÔ‡ Î·È ÙËÓ ·Ó¿Ù˘ÍË ÂÌÈÛÙÔÛ‡ÓË˜ ÌÂ-Ù·Í‡ ıÂÚ¿ÔÓÙÔ˜ Î·È ·ÛıÂÓÔ‡˜.

ñ MÂÙ¿ ·fi ÙËÓ ÏÂÙÔÌÂÚ‹ ÂÈÛÎfiËÛË ÙÔ˘ ÛÙÔÌ·ÙÈ-ÎÔ‡ ‚ÏÂÓÓÔÁfiÓÔ˘ Î·È ÙË ÌË ·ÓÂ‡ÚÂÛË ·ıÔÏÔÁÈÎÒÓÂÍÂÚÁ·ÛÈÒÓ ‰ÈÂÓÂÚÁÔ‡ÓÙ·È ·ÈÌ·ÙÔÏÔÁÈÎ¤˜ Î·È ‚ÈÔ-¯ËÌÈÎ¤˜ ÂÍÂÙ¿ÛÂÈ˜ fiˆ˜: ÁÂÓÈÎ‹ ·›Ì·ÙÔ˜, Û›‰ËÚÔ˜ÔÚÔ‡ , ÊÂÚÈÙÙ›ÓË, Û¿Î¯·ÚÔ, T3, T4, TSH, ÚÂ˘Ì·ÙÔÂÈ-‰‹˜ ·Ú¿ÁÔÓÙ·˜.

ñ H ‰ÈÂÚÂ‡ÓËÛË ·˘Ù‹ ·ÔÛÎÔÂ› ÛÙÔÓ ·ÔÎÏÂÈÛÌfi ÓÔ-ÛËÌ¿ÙˆÓ Ô˘ ¤¯Ô˘Ó Î·Ù¿ Î·ÈÚÔ‡˜ Û˘Ó‰ÂıÂ› ÌÂ ÙË ÛÙÔ-Ì·ÙÔ‰˘Ó›· fiˆ˜ Â›Ó·È: ÔÈ ·Ó·ÈÌ›Â˜, Ô ‰È·‚‹ÙË˜, ÔÈ ÂÓ-‰ÔÎÚÈÓÔÏÔÁÈÎ¤˜ ‰È·Ù·Ú·¯¤˜ Î·È Ù· ·˘ÙÔ¿ÓÔÛ· ÓÔÛ‹-Ì·Ù·.

ñ AÓ ·ÓÂ˘ÚÂıÂ› ÔÔÈ·‰‹ÔÙÂ ·fiÎÏÈÛË ·fi ÙÈ˜ Ê˘ÛÈÔ-ÏÔÁÈÎ¤˜ ÙÈÌ¤˜ Ú¤ÂÈ Ó· Á›ÓÂÈ ·Ú·ÔÌ‹ ÙÔ˘ ·ÛıÂ-ÓÔ‡˜ ÛÙÔÓ ·ÓÙ›ÛÙÔÈ¯Ô ÂÈ‰ÈÎfi ÁÈ· ÂÚ·ÈÙ¤Úˆ ‰ÈÂÚÂ‡ÓË-ÛË Î·È ıÂÚ·Â˘ÙÈÎ‹ ·ÁˆÁ‹.

ñ ™ÙËÓ ÂÚ›ÙˆÛË Ô˘ ‰ÂÓ ·ÓÂ˘ÚÂıÂ› ˘ÔÎÂ›ÌÂÓÔ Ófi-ÛËÌ· Î·È ·ÊÔ‡ Û˘˙ËÙËıÂ› ÂÎ Ó¤Ô˘ Ë È‰È·ÈÙÂÚfiÙËÙ· ÙÔ˘ÓÔÛ‹Ì·ÙÔ˜ Î·ıÒ˜ Î·È Ë ÌË ÂÈÎÈÓ‰˘ÓfiÙËÙ¿ ÙÔ˘, ı·Ú¤ÂÈ Ó· ÚÔÙ·ıÔ‡Ó Î¿ÔÈÂ˜ ıÂÚ·Â›Â˜ ÛÙÔÓ ·ÛıÂ-Ó‹.

ñ OÈ ÚÔÙÂÈÓfiÌÂÓÂ˜ ıÂÚ·Â›Â˜ Â›Ó·È: i) ÙÔÈÎ¤˜ Î·È ·ÊÔ-ÚÔ‡Ó ÛÂ ÛÙÔÌ·ÙÈÎ¤˜ Ï‡ÛÂÈ˜ ÌÂ ÛÔ‰fiÓÂÚÔ &/‹ ¯·ÌÔ-Ì‹ÏÈ Î·ıÒ˜ Î·È ÛÂ ÛÙÔÌ·ÙÈÎ¤˜ Ï‡ÛÂÈ˜ ÌÂ Î·„·˚Î›ÓËii) Û˘ÛÙËÌ·ÙÈÎ¤˜Ô˘ ÍÂÎÈÓÔ‡Ó ·fi Û˘ÌÏËÚÒÌ·Ù· ‰È·-ÙÚÔÊ‹˜ fiˆ˜ ÙÔ ÏÈÔ˚Îfi ÔÍ‡ Î·È ‚ÈÙ·Ì›ÓÂ˜ ÙÔ˘ Û˘-ÌÏ¤ÁÌ·ÙÔ˜ B ÁÈ· Ó· Î·Ù·Ï‹ÍÔ˘Ó, ÛÙÈ˜ ÈÔ Â›ÌÔÓÂ˜ÂÚÈÙÒÛÂÈ˜, ÛÂ ÙÚÈÎ˘ÎÏÈÎ¿ ·ÓÙÈÎ·Ù·ıÏËÙÈÎ¿, ‚ÂÓ˙Ô-‰È·˙Â›ÓÂ˜ Î·È ·ÓÈÂÈÏËÙÈÎ¿.

SUMMARY

Burning Mouth SyndromeMaragou P.


The Burning Mouth Syndrome (BMS) is an intra-oral paindisorder. It is also called oral dysaesthesia, glossalgia orglossodynia when it is localized on the tongue only.The BMS usually affects patients over 50 years old,especially post menopausal women.The pain is almost always described as burning in character,constant, and of increasing intensity within the day. Unlikemany other conditions of the mouth, eating or drinkingoften relieves the discomfort. The intensity of pain variesfrom relatively mild to as strong as a toothache at itsmaximum. It can also be accompanied by nausea, dizziness,headaches and a disturbance in taste.Conditions that have been reported in association withBMS include various nutritional deficiencies, type 2diabetes, chronic anxiety or depression and changes insalivary function. Recent studies have pointed to dysfunctionof several cranial nerves associated with taste sensationas a possible cause of BMS. Even when a patient reportstypical features of BMS, other potential causes should beruled out such as anemias, diabetes, thyroid disfuctionand rheumatoid diseases.The treatment of BMS includes i) Mouth rinse with dilutedcapsaicin as far as it is tolerated ii) oral supplementationof vitamins B and alpha lipoic acid. Persistent cases of

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BMS usually responds well to low dosage of either tricyclicantidepressants, benzodiazepines or anticonvulsants.This study aims to review the epidemiology, the paincharacteristics, the etiologic factors and the managementof BMS syndrome.

Key words: burning mouth syndrome; oral dysaesthesia;glossalgia; glossodynia

BIB§IO°PAºIA1. Ship JA, Grushka M, Lipton JA, Mott AE, Sessle BJ, Dionne

RA: Burning mouth syndrome: an update. J Am DentAssoc1995; 126:842-53.

2. Ben Aryeh H, Gottlieb I, Ish-Shalom S, David A, Szargel H,Laufer D: Oral complaints related to menopause. Maturitas1996; 24:185-9.

3. Klausner JJ: Epidemiology of chronic facial pain: diagnosticusefulnessin patient care. J Am Dent Assoc 1994; 125:1604-11.

4. Grushka M: Clinical features of burning mouth syndrome.Oral Surg Oral Med Oral Pathol 1987; 63:30-6.

5. Svensson P, Kaaber S: General health factors and denturefunction in patients with burning mouth syndrome andmatched control subjects. J Oral Rehabil 1995; 22:887-95.

6. Grispan D, Fermandez Blanco G, Allevato MA, Stengel FM:Burning mouth syndrome. Int J Dermatol 1195; 34:483-7.

7. Gilpin SF: Glossodynia JAMA 1936; 106:1722-4.8. Grushka M, Epstein J, Gorsky M: Burning Mouth Syndrome.

Am Fam Physician 2002; 15: 65(4):615-621.9. Gorsky M, Silverman S, Chinn H: Burning mouth syndrome:

A review of 98 cases. J Oral Med 1987; 42:7-9.10. Zegarelli DJ: Burning mouth: An analysis of 57 patients.Oral

Surg 1984; 58:34-8.11. Hampf G, Ekholm A, Salo T, Ylipaavalniemi P, Aalberg V,

Tuonimen S, Alfthan G: Pain in Oral Galvanism. Pain 1987;29:301-11.

12. Yontchev E, Hakansson B, Hedegard B, Vannerberg NG: Anexamination of the surface corrosion state of dental feelingsand constructions. J Oral Rehabil 1986; 1:365-382.

13. Yontchev E, Meding B, Hedegard B: Contact allergy todental materials in patients with orofacial complaints. J OralRehabil 1986; 13:183-190.

14. §¿ÛÎ·ÚË˜ °: ŒÁ¯ÚˆÌÔ˜ ÕÙÏ·˜ ™ÙÔÌ·ÙÔÏÔÁ›·˜. I·ÙÚÈÎ¤˜EÎ‰. §›ÙÛ·˜. Aı‹Ó·. 1986.

15. Greenberg MS, Lynch MA: Hematologic Disease. In: LynchMA, Brightman VJ, Greenberg MS, 8th ed. Burket’s OralMedicine Diagnosis and Treatment. J.B LippincottCompany. Philadelphia, Pennsylvania. 1984: 727-764.

16. Lamey PJ, Hammond A, Allam BF, McIntosh WB: Vitaminstatus of patients with Burning mouth syndrome andresponse to replacement therapy. Br Dent J 1986; 160:81-84.

17. Grushka M: Clinical features of Burning mouth syndrome.Oral Surg Oral Med Oral Pathol 1987; 63:30-6.

18. Maragou P, Ivanyi L: Serum Zinc Levels in Patients withBurning Mouth Syndrome. Oral Surg Oral Med Oral Pathol1991; 71:447-450.

19. Ferguson MM, Silverman S: Chapter II-Endocrine Disease.In: Jones JH, Mason DK. Oral manifestations of systemicdisease. WB Saunders Co. Ltd. London, Philadelphia. 1980:

297-300.20. Lynch MA: Diabetes. In: Lynch MA, Brightman VJ,

Greenberg MS, 8th ed. Burket’s Oral Medicine Diagnosisand Treatment. J.B Lippincott Company. Philadelphia,Pennsylvania. 1984: 842-851.

21. Basker RM, Sturdee DW, Davenport JC: Patients withburning mouths. A clinical investigation of causative factors,including climacteric and diabetes. Br Dent J 1978; 145:9-16.

22. Greenberg M.S. Clinical and histologic changes of the oralmucosa in pernicious anemia. Oral Surg 1981; 52:38.

23. Zegarelli DJ: Burning mouth: an alternative explanation forsome patients with diabetes mellitus and perniciousanaemia. Ann Dent 1987; 46:23-4.

24. Grushka M, Shupak R, Sessle BJ: A rheumatologicalinvestigation of 27 patients with burning mouth syndrome. JDent Res 1986; 65:533.

25. Forabosco A, Criscuolo M, Coukos G, Uccelli E, WeinsteinR, Spinato S et al: Efficacy of hormone replacement therapyin postmenopausal women with oral discomfort. Oral SurgOral Med Oral Pathol 1992; 73:570-4.

26. Grushka M, Kawalec J, Epstein JB: Burning mouthsyndrome: evolving concepts. Oral Maxillofac Surg ClinNorth Am 2000; 12:287-95.

27. Rojo L, Silvestre FJ, Bagan JV, De Vicente T: Psychiatricmorbidity in burning mouth syndrome. Psychiatric interviewversus depression and anxiety scales. Oral Surg Oral MedOral Pathlol 1993; 75:308-11.

28. Yontchev E, Hedegard B, Carlsson G: Reported symptoms,diseases and medication of patients with orofacialdiscomfort complaints. Int J Oral Maxillofac Surg 1986;15:687-695.

29. Grushka M, Sessle BJ, Miller R: Pain and personality profilesin burning mouth syndrome. Pain 1987;28: 155-167.

30. Fox PC, Busch KA, Baum BJ: Subjective reports ofxerostomia and objective measures of salivary glandperformance. JADA 1987; 115:581-4.

31. Hampf G, Ekholm A, Salo T, Ylipaavalniemi P, Aalberg V,Tuominen S, Alfthan G: Pain in oral galvanism. Pain 1987;29:301-11.

32. Bartoshuk LM, Grushka M, Duffy VB, Fast L, Lucchina L,Prutkin J et al: IJ. Burning mouth syndrome: damage to CN VIIand pain phantoms in CN V. Chem Senses 1999; 24:609-613.

33. Whitehead MC, Beeman CS, Kinsella BA: Distribution oftaste and general sensory nerve endings in fungiformpapillae of the hamster. Am J Anatom 1985; 173:185-201.

34. Lucchina LA, Duffy VB: Special taste loss associated withaging. Chem Senses 1996; 21:636.

35. Yanagisawa l, Bartoshuk LM, Catalanotto FA, Karrer TA,Kveton JF: Anesthesia of the chorda tympani nerve andtaste phantoms. Physiol Behav 1998; 63:329-35.

36. Drucker CR, Jonson TM: Captopril glossopyrosis (letter).Arch Dermatol 1989; 125: 1437-8.

37. Savino LB, Haushalter NM: Lisinopril-induced “scaledmouth syndrome”. Ann Pharmacother 1992; 26:1381-2.

38. http://www.chem.uoa.gr/chemicals/chem_capsaicin.htm, H¯ËÌÈÎ‹ ¤ÓˆÛË ÙÔ˘ Ì‹Ó·: K·„·˚Î›ÓË (NÔ¤Ì‚ÚÈÔ˜ 2006).

39. Bevan S, Szolcsanyi J: “Sensory neuron-specific actions ofcapsaicin: mechanisms and applications”. TrendsPharmacol, Sci.1990; 11:330-333.

40. http://en.wikipedia.org/wiki/Lipoic_acid. Lipoic Acid.

49

∞Ó·ÛÎfiËÛË



∞Ó·ÛÎfiËÛË

10/08/2011.41. Famiano F, Scully C: Burning mouth syndrome (BMS):

double blind controlled study of alpha-lipoic acid (thiocticacid) therapy. J Oral Pathol & Med 2002; 31:267-269.

42. Sharav Y, Singer E, Dionne RA, Dudner R: The analgesiceffect of amitriptyline on chronic facial pain. Pain 1987;31:199-209.

43. Grushka M, Epstein J, Mott A: An open-label, doseescalation pilot study of the effect of clonazepam in burningmouth syndrome. Oral Surg Oral Med Oral Pathl Oral Radiol

Endod 1998; 86:557-61.44. Woda A, Navez ML, Picard P, Gremeau C, Pichard- Leandri

E: A possible therapeutic solution for stomatodynia (burningmouth syndrome). J Orofac Pain; 1998; 12:272-8.

45. Gorsky M, Silverman S, Chinn H: Clinical characteristics andmanagement outcome in the burning mouth syndrome. Anopen study of 130 patients. Oral Surg Oral Med Oral Pathol1991; 72:192-5.

46. Grushka M, Burtoshuk LM: Burning mouth syndrome andoral dysesthesias. Can J Diagnos 2000; June:99-109.

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ÂÚÈÂÏ›ÍÂÈ˜ ÔÏ‡ ÌÂÁ¿ÏÔ˘ ·ÚÈıÌÔ‡ Û˘ÚÌ¿ÙˆÓ. M¤Û·ÛÙÔ Ì·ÁÓ‹ÙË ˘¿Ú¯Ô˘Ó ËÓ›· ÂÎÔÌ‹˜ Î·È Ï‹„Ë˜Ú·‰ÈÔÛËÌ¿ÙˆÓ fiˆ˜ Î·È ËÓ›· ÂÎÏÔÁ‹˜ Î·È ÂÓÙÔÈ-ÛÌÔ‡ ÙË˜ ÂÈÏÂÁfiÌÂÓË˜ ÙÔÌ‹˜.

ñ M›· ÙÚ¿Â˙· ¯ÂÈÚÈÛÌÔ‡ ·fi ˘ÔÏÔÁÈÛÙ¤˜ fiÔ˘ ÂÂ-ÍÂÚÁ¿˙ÔÓÙ·È Ù· Û‹Ì·Ù· Î·È ·Ú¿ÁÂÙ·È Ë ÂÈÎfiÓ· ÛÙËÓÔıfiÓË.

O Ì·ÁÓËÙÈÎfi˜ ÙÔÌÔÁÚ¿ÊÔ˜ ‰ËÌÈÔ˘ÚÁÂ› ÂÈÎfiÓÂ˜ ÙÔÌÒÓÙˆÓ ‰È¿ÊÔÚˆÓ ÙÌËÌ¿ÙˆÓ Î·È ÔÚÁ¿ÓˆÓ ÙÔ˘ ÛÒÌ·ÙÔ˜ ·fi

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B·ÛÈÎ¿ ÛÙÔÈ¯Â›· ÙË˜ Ì·ÁÓËÙÈÎ‹˜ ÙÔÌÔÁÚ·Ê›·˜.EÊ·ÚÌÔÁ¤˜ ÛÙËÓ O‰ÔÓÙÈ·ÙÚÈÎ‹

AÓÙÈÁfiÓË ¢ÂÏ·ÓÙÒÓË*

T· ÙÂÏÂ˘Ù·›· ¯ÚfiÓÈ· ÔÈ ·ÂÈÎÔÓÈÛÙÈÎ¤˜ ÙÂ¯ÓÈÎ¤˜ ÛÙË ÁÓ·ıÔÚÔÛˆÈÎ‹ ÂÚÈÔ¯‹ ¤¯Ô˘Ó ÂÍÂÏÈ-¯ıÂ› È‰È·›ÙÂÚ·. ™Â ·˘Ù¤˜ Û˘ÌÂÚÈÏ·Ì‚¿ÓÂÙ·È Î·È Ô Ì·ÁÓËÙÈÎfi˜ ÙÔÌÔÁÚ¿ÊÔ˜ Ô ÔÔ›Ô˜ Ï¤ÔÓ ¤-¯ÂÈ Á›ÓÂÈ Ì¤ıÔ‰Ô˜ ÂÎÏÔÁ‹˜ ÁÈ· ÙË ÌÂÏ¤ÙË ÛËÌ·ÓÙÈÎÔ‡ ·ÚÈıÌÔ‡ ·ı‹ÛÂˆÓ ÙË˜ ÂÚÈÔ¯‹˜. O ÛÎÔfi˜ ·˘Ù‹˜ ÙË˜ ÂÚÁ·Û›·˜ Â›Ó·È Ó· ·Ó·Ê¤ÚÂÈ ÙÈ˜ Î‡ÚÈÂ˜ ÂÊ·ÚÌÔÁ¤˜ ÙË˜ M·ÁÓËÙÈÎ‹˜ TÔ-ÌÔÁÚ·Ê›·˜ ÛÙËÓ °Ó·ıÔÚÔÛˆÈÎ‹ ÂÚÈÔ¯‹ Î·È ÙËÓ O‰ÔÓÙÈ·ÙÚÈÎ‹ Ú¿ÍË Î·È Ó· ·ÚÔ˘ÛÈ¿ÛÂÈÙ· Î‡ÚÈ· ÛÙÔÈ¯Â›· Ô˘ Ú¤ÂÈ Ó· ÁÓˆÚ›˙ÂÈ Ô ÁÂÓÈÎfi˜ Ô‰ÔÓÙ›·ÙÚÔ˜ ÁÈ· ÙËÓ ÙÂ¯ÓÈÎ‹.TÔ Î˘ÚÈfiÙÂÚÔ ÏÂÔÓ¤ÎÙËÌ· ÙÔ˘ Ì·ÁÓËÙÈÎÔ‡ ÙÔÌÔÁÚ¿ÊÔ˘ Â›Ó·È Ë ·ÂÈÎfiÓÈÛË ÙˆÓ Ì·Ï·ÎÒÓ ÌÔ-Ú›ˆÓ ÙË˜ ÂÚÈÔ¯‹˜ ̄ ˆÚ›˜ ÙËÓ ·ÎÙÈÓÔ‚fiÏËÛË ÙÔ˘ ·ÛıÂÓ‹. H ‰˘Ó·ÙfiÙËÙ· ·˘Ù‹ ÙË˜ Â˘ÎÚÈÓÔ‡˜ ·-ÂÈÎfiÓÈÛË˜ ÙˆÓ Ì·Ï·ÎÒÓ ÌÔÚ›ˆÓ ‰ÂÓ ·Ú·ÙËÚÂ›Ù·È ÛÂ Î·Ì›· ¿ÏÏË ÙÂ¯ÓÈÎ‹ ·ÂÈÎfiÓÈÛË˜ ÙË˜ÂÚÈÔ¯‹˜.OÈ Î˘ÚÈfiÙÂÚÂ˜ ÂÊ·ÚÌÔÁ¤˜ ÙË˜ Ì·ÁÓËÙÈÎ‹˜ ÙÔÌÔÁÚ·Ê›·˜ ÛÙËÓ ÙÚ·¯ËÏÔÚÔÛˆÈÎ‹ ÂÚÈÔ¯‹ Â›-Ó·È ÛÙËÓ ·ÂÈÎfiÓÈÛË ÙË˜ ÎÚÔÙ·ÊÔÁÓ·ıÈÎ‹˜ ‰È¿ÚıÚˆÛË˜ Î·È ÙˆÓ ·ı‹ÛÂÒÓ ÙË˜, ÛÙËÓ ·ÂÈÎfi-ÓÈÛË ÙˆÓ ÛÈÂÏÔÁfiÓˆÓ ·‰¤ÓˆÓ Î·ıÒ˜ Î·È ÛÙËÓ ·ÂÈÎfiÓÈÛË fiÁÎˆÓ ÙË˜ ÂÚÈÔ¯‹˜.


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ÙË ‰È¤ÁÂÚÛË ÙˆÓ ˘Ú‹ÓˆÓ ÙÔ˘ ˘‰ÚÔÁfiÓÔ˘ (ÚˆÙfiÓÈ·)ÙÔ˘ ÛÒÌ·ÙÔ˜ ÔÈ ÔÔ›ÔÈ Û˘ÌÂÚÈÊ¤ÚÔÓÙ·È Û·Ó ÌÈÎÚ¿ Ì·-ÁÓËÙÈÎ¿ ‰›ÔÏ·.H ÂÍ¤Ù·ÛË ·Ú¯›˙ÂÈ ÌÂ ÙËÓ ÂÊ·ÚÌÔÁ‹ ÂÓfi˜ ÂÍˆÙÂÚÈÎÔ‡ Ú·-‰ÈÔÊˆÓÈÎÔ‡ Û‹Ì·ÙÔ˜ Û˘ÁÎÂÎÚÈÌ¤ÓË˜ Û˘¯ÓfiÙËÙ·˜ Î·È ‰È¿Ú-ÎÂÈ·˜. Yfi ÙËÓ Â›‰Ú·ÛË ·˘Ù‹˜ ÙË˜ ÂÍˆÙÂÚÈÎ‹˜ ÂÓ¤ÚÁÂÈ-·˜ Ù· ÚˆÙfiÓÈ· ·ÏÏ¿˙Ô˘Ó ‰È¿Ù·ÍË ÛÙÔ ¯ÒÚÔ Î·È ÂÚÈ-ÛÙÚ¤ÊÔÓÙ·È ÌÂ Û˘ÁÎÂÎÚÈÌ¤ÓË ÁˆÓ›· Î·È Ê¿ÛË. MÂ ÙË ‰È·-ÎÔ‹ ÙÔ˘ ÂÍˆÙÂÚÈÎÔ‡ Û‹Ì·ÙÔ˜ Û˘ÓÙÔÓÈÛÌÔ‡ Ù· ÚˆÙfi-ÓÈ· Â·Ó¤Ú¯ÔÓÙ·È ÛÙËÓ ·Ú¯ÈÎ‹ ÙÔ˘˜ ÂÓÂÚÁÂÈ·Î‹ Î·Ù¿-ÛÙ·ÛË. O ¯ÚfiÓÔ˜ Â·Ó·ÊÔÚ¿˜ ÛÙËÓ ·Ú¯ÈÎ‹ ÙÔ˘˜ ·˘Ù‹Î·Ù¿ÛÙ·ÛË ÔÓÔÌ¿˙ÂÙ·È ̄ ÚfiÓÔ˜ ̄ ·Ï¿ÚˆÛË˜. K·Ù¿ ÙË ‰È¿Ú-ÎÂÈ· ÙË˜ ̄ ·Ï¿ÚˆÛË˜ ·˘Ù‹˜ ÂÎ¤ÌÔ˘Ó Ú·‰ÈÔÛ‹Ì·Ù· Ô˘ÂÓÙÔ›˙ÔÓÙ·È Î·È ·ÓÈ¯ÓÂ‡ÔÓÙ·È ·fi Ù· ÂÈ‰ÈÎ¿ ËÓ›· Ô˘ Â›-Ó·È ÙÔÔıÂÙËÌ¤Ó· Á‡Úˆ ·fi ÙÔ ÛÒÌ· ÙÔ˘ ·ÛıÂÓ‹. TÔ¿ıÚÔÈÛÌ· ·˘ÙÒÓ ÙˆÓ Ú·‰ÈÔÛËÌ¿ÙˆÓ Û¯ËÌ·Ù›˙ÂÈ ÙËÓ ÙÂ-ÏÈÎ‹ ÂÈÎfiÓ· Ì›·˜ Û˘ÁÎÂÎÚÈÌ¤ÓË˜ ÙÔÌ‹˜. H ÙÂÏÈÎ‹ ÂÈÎfiÓ·Ô˘ ‰ËÌÈÔ˘ÚÁÂ›Ù·È ÂÎÊÚ¿˙ÂÈ ÙËÓ ÔÈfiÙËÙ· ÙˆÓ ÈÛÙÒÓ ·fiÙÔ˘˜ ÔÔ›Ô˘˜ ÚÔ¤Ú¯ÂÙ·È Î·È ÙË ı¤ÛË ÙÔ˘˜ ÛÙÔ ̄ ÒÚÔ Î·ÈÂÍ·ÚÙ¿Ù·È ·fi ÙËÓ ˘ÎÓfiÙËÙ· ÙˆÓ ÎÈÓËÙÒÓ ÚˆÙÔÓ›ˆÓÛÙËÓ ˘fi ÂÍ¤Ù·ÛË ÂÚÈÔ¯‹ Î·È ÙÔ˘˜ ¯ÚfiÓÔ˘˜ ¯·Ï¿Úˆ-Û‹˜ ÙÔ˘˜2,3. H ‚·ıÌ›‰ˆÛË ÙÔ˘ Ì·ÁÓËÙÈÎÔ‡ Â‰›Ô˘ ‰›ÓÂÈ ÙË‰˘Ó·ÙfiÙËÙ· Ï‹„Ë˜ ÙÔÌÒÓ ÛÂ ÔÔÈÔ‰‹ÔÙÂ ÂÈı˘ÌËÙfi Â›-Â‰Ô ÛÙÔ ¯ÒÚÔ.OÈ ‚·ÛÈÎ¤˜ ÂÈÎfiÓÂ˜ Ô˘ Ï·Ì‚¿ÓÔÓÙ·È ÛÙËÓ °Ó·ıÔÚÔ-ÛˆÈÎ‹ ÂÚÈÔ¯‹ Â›Ó·È T1 Î·È T2 ·ÎÔÏÔ˘ı›Â˜ Î·ıÒ˜ Î·È T1ÌÂ ÙË ¯Ú‹ÛË ÛÎÈ·ÁÚ·ÊÈÎÔ‡ ˘ÁÚÔ‡. ¶Ú¤ÂÈ Â‰Ò Ó· ÙÔÓÈ-ÛÙÂ› fiÙÈ ÛÙÈ˜ T2 ·ÎÔÏÔ˘ı›Â˜ ‰Â Á›ÓÂÙ·È ÔÙ¤ ¯Ú‹ÛË ÛÎÈ·-ÁÚ·ÊÈÎÔ‡ ˘ÁÚÔ‡.OÈ Î‡ÚÈÂ˜ ÂÊ·ÚÌÔÁ¤˜ ÙË˜ Ì·ÁÓËÙÈÎ‹˜ ÙÔÌÔÁÚ·Ê›·˜ fiˆ˜ÚÔ·Ó·Ê¤ÚıËÎÂ Â›Ó·È ÛÙËÓ ÎÚÔÙ·ÊÔÁÓ·ıÈÎ‹ ‰È¿ÚıÚˆ-ÛË, ÛÙÔ˘˜ ÛÈÂÏÔÁfiÓÔ˘˜ ·‰¤ÓÂ˜ Î·È ÛÂ fiÁÎÔ˘˜ ÙË˜ ÙÚ·-¯ËÏÔÚÔÛˆÈÎ‹˜ ÂÚÈÔ¯‹˜.ø˜ ·ÓÙ¤Ó‰ÂÈÍË ÛÙËÓ ÂÍ¤Ù·ÛË ÌÂ Ì·ÁÓËÙÈÎfi ÙÔÌÔÁÚ¿ÊÔ·Ó·Ê¤ÚÔÓÙ·È ÔÈ Î·Ú‰È·ÎÔ› ‚ËÌ·ÙÔ‰fiÙÂ˜, Ù· ÚfiÛÊ·Ù·ÙÔÔıÂÙËÌ¤Ó· ̆ ÏÈÎ¿ ÔÛÙÂÔÛ‡ÓıÂÛË˜ Î·È Ù· ÂÓ‰ÔÎÚ·ÓÈ·-Î¿ ÌÂÙ·ÏÏÈÎ¿ clips. ¶Ú¤ÂÈ Ó· ÛËÌÂÈˆıÂ› fiÙÈ ·Ó Ù· ˘ÏÈÎ¿ÔÛÙÂÔÛ‡ÓıÂÛË˜ Î·È ÔÈ Î·Ú‰È·ÎÔ› ‚ËÌ·ÙÔ‰fiÙÂ˜ Â›Ó·È ÛÙÔÓ·ÛıÂÓ‹ ¿Óˆ ·fi ¤Ó· ¯ÚfiÓÔ ‰ÂÓ ˘¿Ú¯ÂÈ Î·Ó¤Ó· Úfi-‚ÏËÌ· ÌÂ ÙËÓ ÂÍ¤Ù·Û‹ ÙÔ˘.

T› Â›Ó·È ÔÈ T1 ·ÎÔÏÔ˘ı›Â˜OÈ T1 ÂÈ‚¿Ú˘ÓÛË˜ ·ÎÔÏÔ˘ı›Â˜ Â›Ó·È ÁÓˆÛÙ¤˜ Î·È ̂ ˜ ·Ó·-ÙÔÌÈÎ¤˜ ·ÎÔÏÔ˘ı›Â˜ ÁÈ·ÙÈ ÔÈ ÂÎfiÓÂ˜ ÙÔ˘˜ ¤¯Ô˘Ó ÂÍ·ÈÚÂÙÈ-Î‹ ·ÂÈÎfiÓÈÛË Î·È ·ÓÙ›ıÂÛË. ™Â ·˘Ù¤˜ ·Ú·ÙËÚÔ‡ÓÙ·È ÌÂÛ·Ê‹ÓÂÈ· Ù· fiÚÈ· ‰È·ÊÔÚÂÙÈÎÒÓ ÈÛÙÒÓ. EÂÈ‰‹ ÛÙÈ˜ ·ÎÔ-ÏÔ˘ı›Â˜ ·˘Ù¤˜ Ù· fiÚÈ· ÙˆÓ ÈÛÙÒÓ ·ÔÛ·ÊËÓ›˙ÔÓÙ·È È‰È-·›ÙÂÚ· ÌÂ Ù· ÏÈÒ‰Ë Â›Â‰· ÙˆÓ ÂÚÈÙÔÓÈÒÓ ÔÈ ÂÈÎfiÓÂ˜Ô˘ ·Ú¿ÁÔÓÙ·È ÛÙÈ˜ T1 ·ÎÔÏÔ˘ı›Â˜ Î·ÏÔ‡ÓÙ·È Î·È «ÂÈ-ÎfiÓÂ˜ Ï›Ô˘˜»4. O Î‡ÚÈÔ˜ ÚfiÏÔ˜ ÙˆÓ T1 ÙÔÌÒÓ ÛÙË ÁÓ·-ıÔÚÔÛˆÈÎ‹ ÂÚÈÔ¯‹ ÁÈ· ÙËÓ ·Ú·Ù‹ÚËÛË Î·È ÌÂÏ¤ÙËÙË˜ ·Ó·ÙÔÌ›·˜ ÙË˜ ÂÚÈÔ¯‹˜ ¤¯ÂÈ ÛËÌÂÈˆıÂ› ·fi ÙÔ˘˜ LiÎ·È Û˘Ó.5 ÂÓÒ ÔÈ T1 ÙÔÌ¤˜ ÂÊ·ÚÌfi˙ÔÓÙ·È ÛÙËÓ K°¢ ÁÈ· ÙËÓÌÂÏ¤ÙË ÙÔ˘ ‰È¿ÚıÚÈÔ˘ ‰›ÛÎÔ˘ Î·È ÙË˜ ı¤ÛË˜ ÙÔ˘ Î·ıÒ˜Î·È ÛÂ ÔÚÈÛÌ¤ÓÂ˜ ÂÚÈÙÒÛÂÈ˜ ÛÙÔÓ ÚÔÂÁ¯ÂÈÚËÙÈÎfi ¤ÏÂÁ-¯Ô ÁÈ· ÙÔÔı¤ÙËÛË ÂÌÊ˘ÙÂ˘Ì¿ÙˆÓ6.

T› Â›Ó·È ÔÈ T2 ·ÎÔÏÔ˘ı›Â˜OÈ T2 ·ÎÔÏÔ˘ı›Â˜ ··ÈÙÔ‡Ó ÂÚÈÛÛfiÙÂÚÔ ¯ÚfiÓÔ ÛÙË Ï‹-

„Ë ÙÔ˘˜ ÛÂ Û¯¤ÛË ÌÂ ÙÈ˜ T1 ·ÎÔÏÔ˘ı›Â˜. ™˘¯Ó¿ ·ÔÎ·-ÏÔ‡ÓÙ·È «ÂÈÎfiÓÂ˜ ·ıÔÏÔÁ›·˜» ÁÈ·Ù› ÛÂ ·˘Ù¤˜ ÔÈ Û˘ÏÏÔ-Á¤˜ ˘ÁÚÒÓ ‰›ÓÔ˘Ó ¤ÓÙÔÓÔ Û‹Ì· Î·È ·ÂÈÎÔÓ›˙ÔÓÙ·È ¤Î‰Ë-Ï· ÛÂ Û¯¤ÛË ÌÂ ÙÔ˘˜ ·Ú·ÎÂ›ÌÂÓÔ˘˜ ̄ ·ÌËÏfiÙÂÚË˜ ¤ÓÙ·-ÛË˜ ÈÛÙÔ‡˜. OÈ T2 ÙÔÌ¤˜ Î·ÏÔ‡ÓÙ·È Â›ÛË˜ Î·È ÙÔÌ¤˜ ÓÂ-ÚÔ‡7 Î·È Â›Ó·È ¯Ú‹ÛÈÌÂ˜ ÛÙËÓ ·ÂÈÎfiÓÈÛË ÊÏÂÁÌÔÓÒÓ Î·ÈÓÂÔÏ·ÛÌ¿ÙˆÓ. ™ËÌ·ÓÙÈÎfi Â›Ó·È Ó· ·Ó·ÊÂÚıÂ› fiÙÈ ÛÙÈ˜ T2ÙÔÌ¤˜ ‰ÂÓ Á›ÓÂÙ·È ¯Ú‹ÛË ÛÎÈ·ÁÚ·ÊÈÎÔ‡ ˘ÁÚÔ‡ ÁÈ·Ù› ‰ÂÓÚÔÛ‰›‰ÂÈ Ù›ÔÙ· ÛÙËÓ ÙÂÏÈÎ‹ ·ÂÈÎfiÓÈÛË ÂÊfiÛÔÓ Ù· ̆ ÁÚ¿¤¯Ô˘Ó ˘„ËÏfi Û‹Ì· ÛÙÈ˜ Û˘ÁÎÂÎÚÈÌ¤ÓÂ˜ ÙÔÌ¤˜.

EºAPMO°E™ TH™ MA°NHTIKH™ TOMO°PAºIA™ ™THN O¢ONTIATPIKH1 H ¯Ú‹ÛË ÙÔ˘ Ì·ÁÓËÙÈÎÔ‡ ÙÔÌÔÁÚ¿ÊÔ˘ ÛÙËÓ ÎÚÔÙ·-ÊÔÁÓ·ıÈÎ‹ ‰È¿ÚıÚˆÛËH ·ÂÈÎfiÓÈÛË ÌÂ Ì·ÁÓËÙÈÎfi ÙÔÌÔÁÚ¿ÊÔ Â›Ó·È ÛÂ ı¤ÛË Ó··Ú¤¯ÂÈ ˘„ËÏ‹˜ ÔÈfiÙËÙ·˜ ÂÈÎfiÓÂ˜ ÌÂ ÔÏ‡ Î·Ï‡ÙÂÚË·ÓÙ›ıÂÛË ÌÂÙ·Í‡ ÙˆÓ Ì·Ï·ÎÒÓ ÈÛÙÒÓ ·fi ÙÈ˜ Û˘Ì‚·ÙÈÎ¤˜ÙÂ¯ÓÈÎ¤˜ Î·È ÂÈÏ¤ÔÓ ¤¯ÂÈ ÙÔ ÏÂÔÓ¤ÎÙËÌ· fiÙÈ ‰Â ¯ÚËÛÈ-ÌÔÔÈÂ›Ù·È ÈÔÓ›˙Ô˘Û· ·ÎÙÈÓÔ‚ÔÏ›· ÁÈ· ÙË Û˘ÁÎÂÎÚÈÌ¤ÓË ÙÂ-¯ÓÈÎ‹8.£ÂˆÚÂ›Ù·È Ë ÈÔ ·ÎÚÈ‚‹˜ Ì¤ıÔ‰Ô˜ ÁÈ· ÙËÓ ·ÂÈÎfiÓÈÛË ÙË˜ı¤ÛË˜ ÙÔ˘ ‰È¿ÚıÚÈÔ˘ ‰›ÛÎÔ˘ ÛÙËÓ ¿ÚıÚˆÛË Î·È ÙÔ˘ Û¯‹-Ì·Ùfi˜ ÙÔ˘. E›ÛË˜ ÛËÌ·ÓÙÈÎfi Â›Ó·È ÙÔ ÁÂÁÔÓfi˜ fiÙÈ ÌÂ ÙËÓÙÂ¯ÓÈÎ‹ ·˘Ù‹ ·ÂÈÎÔÓ›˙ÂÙ·È ÙÔ fiÚÈÔ ÌÂÙ·Í‡ ‰È¿ÚıÚÈÔ˘ ‰›-ÛÎÔ˘ Î·È Û˘Ó‰¤ÛÌˆÓ. H ‰È·ÁÓˆÛÙÈÎ‹ ·ÎÚ›‚ÂÈ· ÙË˜ Ì·-ÁÓËÙÈÎ‹˜ ÙÔÌÔÁÚ·Ê›·˜ ÛÙ· ÛÙÔÈ¯Â›· ÙÔ˘ ‰È¿ÚıÚÈÔ˘ ‰›-ÛÎÔ˘ Â›Ó·È ÔÏ‡ ÌÂÁ·Ï‡ÙÂÚË ·fi ·˘Ù‹ ÙË˜ ·ÚıÚÔÁÚ·-Ê›·˜ Î·È ÂÈÏ¤ÔÓ ‰ÂÓ ˘¿Ú¯ÂÈ Î·Ì›· ·Ú¤Ì‚·ÛË Ë ÚÔ-‚Ï‹Ì·Ù· Î·Ù¿ ÙËÓ ÂÍ¤Ù·ÛË. O˘ÛÈ·ÛÙÈÎ¿ Â›Ó·È Ë ÙÂ¯ÓÈÎ‹ ËÔÔ›· ·ÓÙÈÎ·Ù¤ÛÙËÛÂ ÙËÓ ·ÚıÚÔÁÚ·Ê›·9-11. EÈÏ¤ÔÓ Û·ÓÙÂ¯ÓÈÎ‹ ¤¯ÂÈ ÙË ‰˘Ó·ÙfiÙËÙ· ·ÂÈÎfiÓÈÛË˜ Î·È ÙˆÓ ÔÛÙÈÎÒÓ·ÏÏÔÈÒÛÂˆÓ Ô˘ ·Ú·ÙËÚÔ‡ÓÙ·È ÛÙËÓ ¿ÚıÚˆÛË ·fi ÙËÓÂÍ¤ÏÈÍË ÙˆÓ ·ı‹ÛÂˆÓ ÛÙËÓ K°¢ fiˆ˜ ÔÛÙÂfiÊ˘Ù· Î·È ÌÂÙÔÓ ÙÚfiÔ ·˘Ùfi ÌÂÏÂÙ¿Ù·È Î·È Ë ÂÍ¤ÏÈÍË ÙË˜ ÓfiÛÔ˘. AÓÎ·È Ë ·ÍÔÓÈÎ‹ ÙÔÌÔÁÚ·Ê›· Î·È Ë ·ÚıÚÔÁÚ·Ê›· ÂÍ·ÎÔ-ÏÔ˘ıÔ‡Ó Ó· ¤¯Ô˘Ó ÙÔ ÚfiÏÔ ÙÔ˘˜ ÛÙËÓ ÌÂÏ¤ÙË ÙË˜ K°¢ ËÌ·ÁÓËÙÈÎ‹ ÙÔÌÔÁÚ·Ê›· ·ÔÙÂÏÂ› ÙËÓ ÂÍ¤Ù·ÛË ÂÈÏÔÁ‹˜ÛÙËÓ ÂÛˆÙÂÚÈÎ‹ ·ÔÚÚ‡ıÌÈÛË ÙË˜ ¿ÚıÚˆÛË˜. OÈ ·ÎÔ-ÏÔ˘ı›Â˜ Ô˘ ÂÊ·ÚÌfi˙ÔÓÙ·È ÁÈ· ÙËÓ ·ÂÈÎfiÓÈÛË ÙË˜ ÎÚÔ-Ù·ÊÔÁÓ·ıÈÎ‹˜ ‰È¿ÚıÚˆÛË˜ Û˘Ó‹ıˆ˜ ÂÚÈÔÚ›˙ÔÓÙ·È ÛÙÈ˜

52

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EÈÎ. 1: º˘ÛÈÔÏÔ-ÁÈÎ‹ ·ÂÈÎfiÓÈÛËÎÚÔÙ·ÊÔÁÓ·ıÈ-Î‹˜ ÛÙË ‰ÂÍÈ¿ ¿ÚıÚˆÛË ·ÛıÂÓ‹(ÂÈÎfiÓÂ˜ ÌÂ ÎÏÂÈÛÙfi Î·È ·ÓÔÈÎÙfi ÛÙfiÌ·)


T1 ·ÎÔÏÔ˘ı›Â˜ Î˘Ú›ˆ˜ ÁÈ· ÙË ÌÂÏ¤ÙË ÙÔ˘ ‰È¿ÚıÚÈÔ˘ ‰›-ÛÎÔ˘.ŒÓ· ÚˆÙfiÎÔÏÏÔ ÌÂÏ¤ÙË˜ Î·È ÂÍ¤Ù·ÛË˜ ÙË˜ K°¢ ÌÂ ÙÈ˜Î·ÙËÁÔÚ›Â˜ Î·È ÙÈ˜ ‰È·ÓÔÌ¤˜ ÙˆÓ ı¤ÛÂˆÓ ÙÔ˘ ‰È¿ÚıÚÈÔ˘‰›ÛÎÔ˘ ¤¯ÂÈ ÚÔÙ·ıÂ› ·fi ÙÔ˘˜ Larheim Î·È Westesson12.H Û˘ÏÏÔÁ‹ ̆ ÁÚÔ‡ ÛÙÔ ‰È¿ÚıÚÈÔ ̄ ÒÚÔ Ô˘ ÌÔÚÂ› Ó· Û¯Â-Ù›˙ÂÙ·È ÌÂ fiÓÔ Î·È Ô›‰ËÌ· ÛÙËÓ ÂÚÈÔ¯‹ Î·È ÊÏÂÁÌÔÓÒ-

‰ÂÈ˜ ‰ÈÂÚÁ·Û›Â˜ ÙË˜ ÂÚÈÔ¯‹˜ ‰ÂÓ·Ú·ÙËÚÔ‡ÓÙ·È ÛÙÈ˜ T1 ÙÔÌ¤˜ Î·ÈÌÂ ‰˘ÛÎÔÏ›· ÔÏÏ¤˜ ÊÔÚ¤˜ ·-Ú·ÙËÚÔ‡ÓÙ·È Î·È ÛÙÈ˜ T2 ÙÔÌ¤˜,ÂÓÒ Ë ÙÂ¯ÓÈÎ‹ Ô˘ Û˘Ó›ÛÙ·Ù·È ÁÈ·ÙË Û˘ÏÏÔÁ‹ ÙÔ˘ ̆ ÁÚÔ‡ Â›Ó·È Ë Î·-Ù·ÛÙÔÏ‹ ÙÔ˘ Ï›Ô˘˜ (fatsuppression) Ô˘ ·Ó·‰ÂÈÎÓ‡ÂÈ ÙÔ˘„ËÏfi Û‹Ì· ÙˆÓ Û˘ÏÏÔÁÒÓ. ™ÙËÛ˘ÓËı¤ÛÙÂÚË ¿ıËÛË ÙË˜ ÎÚÔ-Ù·ÊÔÁÓ·ıÈÎ‹˜ ‰È¿ÚıÚˆÛË˜, ÙË˜ÚfiÛıÈ·˜ ÌÂÙ·ÙfiÈÛË˜ ÙÔ˘ ÎÔÓ-‰‡ÏÔ˘ ÛÂ ÎÏÂÈÛÙfi ÛÙfiÌ· ·Ú·-ÙËÚÂ›Ù·È ÌÂÙ·ÙfiÈÛË ÙÔ˘ ‰›ÛÎÔ˘ÚfiÛıÈ· ÙÔ˘ ÎÔÓ‰‡ÏÔ˘, ÂÓÒ ÛÂ·ÓÔÈÎÙfi ÛÙfiÌ· Ë Ô›ÛıÈ· ÌÔ›Ú·ÙÔ˘ ‰›ÛÎÔ˘ ¤Ú¯ÂÙ·È ÛÂ Ê˘ÛÈÔÏÔ-ÁÈÎ‹ ı¤ÛË fiÈÛıÂÓ ÙÔ˘ ÎÔÓ‰‡ÏÔ˘

(ÂÈÎ. 1-2).

2 H ̄ Ú‹ÛË ÙÔ˘ Ì·ÁÓËÙÈÎÔ‡ ÙÔÌÔÁÚ¿ÊÔ˘ ÛÙË ‰È¿ÁÓˆÛËÙˆÓ ·ı‹ÛÂˆÓ ÙˆÓ ÛÈÂÏÔÁfiÓˆÓ ·‰¤ÓˆÓH ·ÂÈÎfiÓÈÛË ÙˆÓ ÛÈÂÏÔÁfiÓˆÓ ·‰¤ÓˆÓ ÌÂ ÙË ¯Ú‹ÛË ÙË˜Ì·ÁÓËÙÈÎ‹˜ ÙÔÌÔÁÚ·Ê›·˜ Â›Ó·È Ì›· Ì¤ıÔ‰Ô˜ Ô˘ ·Ú¿-ÁÂÈ ˘„ËÏ‹˜ ÔÈfiÙËÙ·˜ ÂÈÎfiÓÂ˜ ÛÂ ·˘ÙÔ‡˜ Î·ıÒ˜ Î·È ÛÂ¿ÏÏÂ˜ ÂÚÈÔ¯¤˜ ÙÔ˘ ÛÒÌ·ÙÔ˜13.T1 Î·È T2 ·ÎÔÏÔ˘ı›Â˜ Î·ıÒ˜ Î·È proton density-weightedimages, ¯ÚËÛÈÌÔÔÈÔ‡ÓÙ·È ÁÈ· ÙËÓ ·ÂÈÎfiÓÈÛË ÙˆÓ ÛÈÂ-ÏÔÁfiÓˆÓ ·‰¤ÓˆÓ, ÂÓÒ ÔÈ T2 diffusion weighted ·ÎÔÏÔ˘-ı›Â˜ ¯ÚËÛÈÌÔÔÈÔ‡ÓÙ·È ÁÈ· ÙË ‰È¿ÁÓˆÛË ÙÔ˘ fiÁÎÔ˘ ÙÔ˘Warthin. OÈ T1 ·ÎÔÏÔ˘ı›Â˜ ‰Â›¯ÓÔ˘Ó ÂÍ·ÈÚÂÙÈÎ¿ ÙÔ Ï›Ô˜‰›ÓÔÓÙ·˜ ˘„ËÏfi Û‹Ì·. O ÏÈÒ‰Ë˜ ÈÛÙfi˜ ÂÔÌ¤Óˆ˜ Ê·›-ÓÂÙ·È ÏÂ˘Îfi˜ ÛÙËÓ ÙÂÏÈÎ‹ ÂÈÎfiÓ·. OÈ Ì‡Â˜ ‰›ÓÔ˘Ó ÏÈÁfiÙÂ-ÚÔ ˘„ËÏfi Û‹Ì· Î·È ÁÈ· ·˘Ùfi ·Ú·ÙËÚÔ‡ÓÙ·È ¯·ÌËÏfiÙÂ-ÚË˜ ¤ÓÙ·ÛË˜ ÛÂ Û¯¤ÛË ÌÂ ÙÔ Ï›Ô˜14. O Ê˘ÛÈÔÏÔÁÈÎfi˜ ·-ÚˆÙÈ‰ÈÎfi˜ ÈÛÙfi˜ ÂÈ‰ÂÈÎÓ‡ÂÈ ¤Ó· ÂÓ‰È¿ÌÂÛË˜ ¤ÓÙ·ÛË˜ Û‹-Ì· ÌÂÙ·Í‡ ÙÔ˘ Ï›Ô˘˜ Î·È ÙˆÓ Ì˘ÒÓ. §fiÁˆ fiÌˆ˜ ÙÔ˘ ̆ „Ë-ÏÔ‡ ÔÛÔÛÙÔ‡ ÛÂ Ï›Ô˜ ÙÔ˘ ·‰¤Ó· ¤¯ÂÈ ÌÈÎÚ‹ ÂÚ›Ô‰Ô¯¿Ï·ÛË˜ ÛÙÈ˜ T1 ÂÈ‚¿Ú˘ÓÛË˜ ·ÎÔÏÔ˘ı›Â˜ (short T1relaxing time) Î·È ÙÔ Û‹Ì· ÚÔÛÂÁÁ›˙ÂÈ ÛÂ ·˘Ùfi ÙÔ˘ ÏÈ-Ò‰Ô˘˜ ÈÛÙÔ‡15.

H ¤ÓÙ·ÛË Û‹Ì·ÙÔ˜ ÙÔ˘ ˘ÔÁÓ¿-ıÈÔ˘ Â›Ó·È ¯·ÌËÏfiÙÂÚË ÙË˜ ·-ÚˆÙ›‰·˜ Î·È ÚÔÛÂÁÁ›˙ÂÈ ÂÚÈÛ-ÛfiÙÂÚÔ ·˘Ùfi ÙˆÓ Ì˘ÒÓ ÛÙÈ˜ T1·ÎÔÏÔ˘ı›Â˜14,16. OÈ T2 ÙÔÌ¤˜ Â›Ó·ÈÏÈÁfiÙÂÚÔ Â˘ÎÚÈÓÂ›˜ ·ÏÏ¿ ÛÂ Û˘Ó-‰˘·ÛÌfi ÌÂ ÙËÓ Î·Ù·ÛÙÔÏ‹ ÙÔ˘ Û‹-Ì·ÙÔ˜ ÙÔ˘ Ï›Ô˘˜ ÚÔÛ‰›‰Ô˘Ó Î·-Ï‡ÙÂÚË ÂÈÎfiÓ· ÛÂ ÂÚÈÙÒÛÂÈ˜·ÂÈÎfiÓÈÛË˜ fiÁÎˆÓ. °ÂÓÈÎ¿ Ë Ì·ÁÓËÙÈÎ‹ ÙÔÌÔÁÚ·Ê›·˘ÂÚÙÂÚÂ› ÙË˜ ·ÍÔÓÈÎ‹˜ ÙÔÌÔ-ÁÚ·Ê›·˜ ÛÂ Û¯¤ÛË ÌÂ ÙÔ ‰È·¯ˆ-ÚÈÛÌfi ÂÓ‰Ô Î·È ÂÍˆ·‰ÂÓÈÎÒÓ ÛÙÔÈ-¯Â›ˆÓ Î·È ÈÛÙÒÓ, ÏfiÁˆ ÙË˜ ˘„Ë-ÏfiÙÂÚË˜ ÈÎ·ÓfiÙËÙ·˜ ·ÓÙ›ıÂÛË˜Ô˘ ‰È·ı¤ÙÂÈ ÌÂÙ·Í‡ ÙˆÓ Ì·Ï·-ÎÒÓ ÈÛÙÒÓ.

53

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EÈÎ. 2: ¶ÚfiÛıÈ· ÌÂÙ·Ùfi-ÈÛË ÙÔ˘ ‰›ÛÎÔ˘ÛÙËÓ ·ÚÈÛÙÂÚ‹¿ÚıÚˆÛË ÙÔ˘ ›‰È-Ô˘ ·ÛıÂÓ‹ ÌÂÎÏÂÈÛÙfi Î·È ·ÓÔÈ-ÎÙfi ÛÙfiÌ· fiÔ˘Ê·›ÓÂÙ·È Ë ·ÚÂ-ÎÙfiÈÛË ÙÔ˘ ‰›-ÛÎÔ˘ ÛÙÔ ÎÏÂÈÛÙfiÛÙfiÌ· Î·È Ë ÌÂÚÈ-Î‹ Â·Ó·ÊÔÚ¿ÙÔ˘ Î·Ù¿ ÙË ‰È¿-ÓÔÈÍË

TÔ Î‡ÚÈÔ ÏÂÔÓ¤ÎÙËÌ· ÙË˜ Ì·ÁÓËÙÈÎ‹˜ ÙÔÌÔÁÚ·Ê›·˜ Â›-Ó·È Ë ‰È·ÎÚÈÙÈÎ‹ ÙË˜ ÈÎ·ÓfiÙËÙ· ÛÙ· ·Ó·ÙÔÌÈÎ¿ fiÚÈ· ÙÔ˘·‰¤Ó·. TÔ ÂÍˆ·‰ÂÓÈÎfi Ì¤ÚÔ˜ ÙˆÓ ·ÏÏÔÈÒÛÂˆÓ ÂÈÛ¤Ú¯Â-Ù·È ÛÙÔÓ ÂÚÈ·‰ÂÓÈÎfi ÏÈÒ‰Ë Î·È Ì˘ÈÎfi ÈÛÙfi Î·È ÁÈ· ÙÔ Ïfi-ÁÔ ·˘Ùfi Â›Ó·È Î·Ïfi Ó· Á›ÓÔÓÙ·È Ï‹„ÂÈ˜ Î·È T1 Î·È T1 fatsat ÙÔÌÒÓ(ÌÂ Î·Ù·ÛÙÔÏ‹ Ï›Ô˘˜) Î·È T2 ÙÔÌÒÓ (ÂÈÎ. 3).°ÂÓÈÎ¿ ÛÙÈ˜ T2 ÙÔÌ¤˜ Ô˘ ‰ÂÓ Â›Ó·È ÔÈ Û˘Ó‹ıÂÈ˜ ÁÈ· ÙËÓ·ÂÈÎfiÓÈÛË ÙˆÓ ÛÈÂÏÔÁfiÓˆÓ ·‰¤ÓˆÓ ÙÔ Ï›Ô˜ ·ÂÈÎÔÓ›-˙ÂÙ·È ÈÔ ÛÎÔ‡ÚÔ ÂÓˆ Ù· ˘ÁÚ¿ ÈÔ ·ÓÔÈ¯Ù¿ (ÂÓÙÔÓfiÙÂÚÔÛ‹Ì·) Î·È ÔÈ Ì‡Â˜ ‰›ÓÔ˘Ó ̄ ·ÌËÏ‹˜ ¤ÓÙ·ÛË˜ Û‹Ì· ÌÂ ·Ô-Ù¤ÏÂÛÌ· Ó· ·ÂÈÎÔÓ›˙ÔÓÙ·È ÈÔ ÛÎÔ‡ÚÔÈ.EÈÏ¤ÔÓ Ë Ï‹„Ë ÙÔÌÒÓ T1 ÂÈ‚¿Ú˘ÓÛË˜ ÌÂ Î·Ù·ÛÙÔÏ‹ÙÔ˘ Ï›Ô˘˜ ÌÂÙ¿ ÙË ¯ÔÚ‹ÁËÛË ÛÎÈ·ÁÚ·ÊÈÎÔ‡ ˘ÁÚÔ‡ ·˘-Í¿ÓÂÈ ·ÎfiÌ· ÂÚÈÛÛfiÙÂÚÔ ÙËÓ ·ÓÙÈıÂÙÈÎ‹ ÈÎ·ÓfiÙËÙ· ÙÔ˘Ì·ÁÓËÙÈÎÔ‡ ÙÔÌÔÁÚ¿ÊÔ˘ ÛÙË ‰ÈÂÚÂ‡ÓËÛË fiÁÎˆÓ16. T¤ÏÔ˜ ÛÙËÓ ·ÂÈÎfiÓÈÛË ÙˆÓ ÛÈÂÏÔÁfiÓˆÓ ·‰¤ÓˆÓ Î·È ÁÈ·‰È·ÊÔÚÈÎ‹ ‰È¿ÁÓˆÛË Î¿ÔÈˆÓ ·ıÔÏÔÁÈÎÒÓ Î·Ù·ÛÙ¿ÛÂ-ˆÓ ¯ÚËÛÈÌÔÔÈÔ‡ÓÙ·È Û˘ÁÎÂÎÚÈÌ¤ÓÂ˜ ·ÎÔÏÔ˘ı›Â˜. ŒÙÛÈÛÙÈ˜ T2 diffusion weighted ÂÈÎfiÓÂ˜ Ô fiÁÎÔ˜ ÙÔ˘ Warthin‰›ÓÂÈ ˘„ËÏfi Û‹Ì· Î·È «·ÛÚ›˙ÂÈ» ÛÙËÓ ÂÈÎfiÓ·, ‰›ÓÔÓÙ·˜¯·Ú·ÎÙËÚÈÛÙÈÎ‹ ÂÈÎfiÓ· Î·È Ô˘ÛÈ·ÛÙÈÎ¿ ı¤ÙÂÈ ÙË ‰È¿ÁÓˆ-ÛË (ÂÈÎ. 4).

3 H ̄ Ú‹ÛË ÙÔ˘ Ì·ÁÓËÙÈÎÔ‡ ÙÔÌÔÁÚ¿ÊÔ˘ ÛÙË ‰È¿ÁÓˆÛËÙˆÓ fiÁÎˆÓ ÙË˜ ÙÚ·¯ËÏÔÚÔÛˆÈÎ‹˜ ÂÚÈÔ¯‹˜OÈ Î·ÎÔ‹ıÂÈÂ˜ ÙË˜ ÙÚ·¯ËÏÔÚÔÛˆÈÎ‹˜ ÂÚÈÔ¯‹˜, ·ÓÙÈ-ÚÔÛˆÂ‡Ô˘Ó ÙÔ 2-5% fiÏˆÓ ÙˆÓ Î·ÎÔËıÂÈÒÓ17. Afi ·˘-Ù¤˜ ÙÔ 90% ÂÚ›Ô˘ Â›Ó·È Î·ÚÎÈÓÒÌ·Ù· ÙˆÓ Ï·Îˆ‰ÒÓÎ˘ÙÙ¿ÚˆÓ. §fiÁˆ ÙË˜ ÁÂÈÙÓ›·ÛË˜ ÙË˜ ÛÙÔÌ·ÙÈÎ‹˜ ÎÔÈÏfi-ÙËÙ·˜ ÌÂ Ì›· ÏÂÈ¿‰· ÏÂÌÊ·‰¤ÓˆÓ, Â›Ó·È È‰È·›ÙÂÚ· ÛË-Ì·ÓÙÈÎ‹ Ë ÛˆÛÙ‹ ÚÔÂÁ¯ÂÈÚËÙÈÎ‹ ‰È¿ÁÓˆÛË ÙÔ˘ ·ÛıÂÓ‹.O Î‡ÚÈÔ˜ ÚfiÏÔ˜ ÙË˜ Ì·ÁÓËÙÈÎ‹˜ ÙÔÌÔÁÚ·Ê›·˜ ÛÙËÓ Â-ÚÈÔ¯‹ Â›Ó·È Ó· Î·ıÔÚÈÛÙÂ› ÙÔ ‚¿ıÔ˜, Ë Î·ÙÂ‡ı˘ÓÛË Î·È ÙÔÌ¤ÁÂıÔ˜ ÙÔ˘ fiÁÎÔ˘18 Î·ıÒ˜ Î·È Ë ÁÂÈÙÓ›·ÛË ÙÔ˘ ÌÂ ·-Ú·ÎÂ›ÌÂÓ· ·Ó·ÙÔÌÈÎ¿ ÛÙÔÈ¯Â›·19-22.ŸÏÔÈ ÔÈ fiÁÎÔÈ ÙË˜ ÂÚÈÔ¯‹˜ Ú¤ÂÈ Ó· ıÂˆÚÔ‡ÓÙ·È ÌÂ Ì·-ÁÓËÙÈÎ‹ ÙÔÌÔÁÚ·Ê›· ÏfiÁˆ ÙË˜ ˘„ËÏ‹˜ ‰È·ÎÚÈÙÈÎ‹˜ ÈÎ·-ÓfiÙËÙ·˜ Î·È Î·Ï‡ÙÂÚË˜ ·ÓÙ›ıÂÛË˜ ÛÂ Û¯¤ÛË ÌÂ ÙËÓ ·ÍÔ-ÓÈÎ‹ ÙÔÌÔÁÚ·Ê›· Î·È ÂÈ‰ÈÎfiÙÂÚ· ÌÂ T2 ÙÔÌ¤˜24-28. E›ÛË˜ÛËÌ·ÓÙÈÎfi Â›Ó·È ÙÔ ÛÙÔÈ¯Â›Ô fiÙÈ ÛÙËÓ Ì·ÁÓËÙÈÎ‹ ÙÔÌÔ-

ÁÚ·Ê›· ‰ÂÓ ¤¯Ô˘ÌÂ ÙfiÛÔ ¤ÓÙÔÓ· ÙËÓ ÂÈÎfiÓ· ÙˆÓ artifactsÌÂ ·ÔÙ¤ÏÂÛÌ· ÛËÌ·ÓÙÈÎ¿ Î·Ï‡ÙÂÚË ‰È·ÁÓˆÛÙÈÎ‹ Â˘ÎÚ›-ÓÂÈ·. K·Ïfi Â›Ó·È Ó· Á›ÓÔÓÙ·È Î·È ÔÈ T1 Î·È ÔÈ T2 ·ÎÔÏÔ˘-

54

∞Ó·ÛÎfiËÛË

EÈÎ. 3: ¶ÏÂÈfiÌÔÚÊÔ ·‰¤ÓˆÌ· ·ÚˆÙ›‰·˜ ÛÂ T1 ÙÔÌ‹, T1 ÙÔÌ‹ ÌÂ Î·Ù·ÛÙÔÏ‹ ÙÔ˘ Ï›Ô˘˜ Î·È ¯Ú‹ÛË ÛÎÈ·ÛÙÈÎÔ‡ Î·È ÛÂT2 ÙÔÌ‹ fiÔ˘ ‰È·Ê·›ÓÂÙ·È Û·Ê¤ÛÙÂÚ· ÙÔ fiÚÈÔ ÙÔ˘ fiÁÎÔ˘ ÛÙÔ˘˜ ·Ú·ÎÂ›ÌÂÓÔ˘˜ ÈÛÙÔ‡˜

EÈÎ. 4: T1 ÙÔÌ¤˜ ÌÂ Î·Ù·ÛÙÔÏ‹ ÙÔ˘ Ï›Ô˘˜ Î·È ¯Ú‹ÛË ÛÎÈ·ÛÙÈÎÔ‡

T2 ÙÔÌ¤˜ fiÔ˘ ‰È·Ê·›ÓÂÙ·È Ô fiÁÎÔ˜ ·ÌÊÔÙÂÚfiÏÂ˘Ú· ÛÙÔ˘˜Î¿Ùˆ Î˘Ú›ˆ˜ ÏÔ‚Ô‡˜

T2 diffusion weighted ÂÈÎfiÓÂ˜ Ô˘ ¯ÚËÛÈÌÔÔÈÔ‡ÓÙ·È ÁÈ· ÙË ‰È·-ÊÔÚÈÎ‹ ‰È¿ÁÓˆÛË ÙˆÓ ‰‡Ô ·ı‹ÛÂˆÓ. O fiÁÎÔ˜ ÙÔ˘ Warthin ‰›ÓÂÈ˘„ËÏfi Û‹Ì· Î·È «·ÛÚ›˙ÂÈ» ÛÙËÓ ÂÈÎfiÓ·. ŒÙÛÈ Á›ÓÂÙ·È ‰È·ÊÔÚÈÎ‹‰È¿ÁÓˆÛË fiÁÎÔ˘ ÙÔ˘ Warthin Î·È ÏÂÈfiÌÔÚÊÔ˘ ·‰ÂÓÒÌ·ÙÔ˜.


ı›Â˜ Î·ıÒ˜ Î·È T1 ·ÎÔÏÔ˘ı›Â˜ ÌÂ ÙË ¯Ú‹ÛË ÛÎÈ·ÛÙÈÎÔ‡.O ÁÈ·ÙÚfi˜ ÌÔÚÂ› Ó· Û˘ÁÎÚ›ÓÂÈ ÙÈ˜ ‰È¿ÊÔÚÂ˜ ·ÎÔÏÔ˘ı›Â˜ÌÂÙ·Í‡ ÙÔ˘˜ Î·È Ó· ¤¯ÂÈ Î·Ï‡ÙÂÚË ·ÂÈÎfiÓÈÛË ÙÔ˘ fiÁÎÔ˘Î·È ÙˆÓ ·Ú·ÎÂ›ÌÂÓˆÓ ·Ó·ÙÔÌÈÎÒÓ ‰ÔÌÒÓ (ÂÈÎ. 5). ™ËÌ·-ÓÙÈÎfi Â›Ó·È Ó· ÁÓˆÚ›˙ÂÈ ÙËÓ ·Ó·ÙÔÌ›· ÙË˜ ÂÚÈÔ¯‹˜ Î·È Ó·ÌÔÚÂ› Ó· ·ÓÈ¯ÓÂ‡ÛÂÈ Ù· ·ıÔÏÔÁÈÎ¿ ÛÙÔÈ¯Â›· Ô˘ ÙÔÓ ÂÓ-‰È·Ê¤ÚÔ˘Ó.

™YM¶EPA™MATAOÈ ÂÊ·ÚÌÔÁ¤˜ ÙË˜ Ì·ÁÓËÙÈÎ‹˜ ÙÔÌÔÁÚ·Ê›·˜ ÛÙËÓ ‰È¿-ÁÓˆÛË ÙˆÓ ·ı‹ÛÂˆÓ ÙË˜ ÙÚ·¯ËÏÔÚÔÛˆÈÎ‹˜ ÂÚÈÔ-¯‹˜ Û˘ÓÂ¯Ò˜ ·˘Í¿ÓÔÓÙ·È. ¶ÔÏÏÔ› ıÂˆÚÔ‡Ó fiÙÈ ÛÙÔ Ì¤Ï-ÏÔÓ Ë Ì·ÁÓËÙÈÎ‹ ÙÔÌÔÁÚ·Ê›· ı· ·ÔÙÂÏ¤ÛÂÈ ¤Ó· Î·ıË-ÌÂÚÈÓfi ‰È·ÁÓˆÛÙÈÎfi ÂÚÁ·ÏÂ›Ô ÛÙËÓ ÂÚÈÔ¯‹. ™ÙÈ˜ Ì¤ÚÂ˜Ì·˜ ÔÈ ÂÊ·ÚÌÔÁ¤˜ ÙË˜ ÂÚÈÔÚ›˙ÔÓÙ·È ·fi ÙÔ ˘„ËÏfi Îfi-ÛÙÔ˜ ÙË˜ ÙÂ¯ÓÈÎ‹˜ Î·È ÙË ÔÏ˘ÏÔÎfiÙËÙ· ÙË˜ ·Ó¿ÁÓˆÛ‹˜ÙË˜. B·ÛÈÎfi ÏÂÔÓ¤ÎÙËÌ·, fiÌˆ˜, ÁÈ· ÙËÓ ÂÊ·ÚÌÔÁ‹ ÙË˜·ÔÙÂÏÂ› ÙÔ ÁÂÁÔÓfi˜ fiÙÈ ‰È·ÊÔÚÔÔÈÂ› ÌÂ È‰È·›ÙÂÚË Â˘-ÎÚ›ÓÂÈ· ÙÔ˘˜ ·Ú·ÎÂ›ÌÂÓÔ˘˜ ÙˆÓ ·ıÔÏÔÁÈÎÒÓ Î·Ù·ÛÙ¿-ÛÂˆÓ ÈÛÙÔ‡˜ Î·È ‰ÂÓ ·ÎÙÈÓÔ‚ÔÏÂ› ÙÔÓ ·ÛıÂÓ‹. ™˘ÌÂÚ·-

ÛÌ·ÙÈÎ¿ Ù· ÏÂÔÓÂÎÙ‹Ì·Ù· Î·È Ù· ÌÂÈÔÓÂÎÙ‹Ì·Ù· ÙË˜ ÙÂ-¯ÓÈÎ‹˜ Ê·›ÓÔÓÙ·È ÛÙÔÓ ›Ó·Î·.

SUMMARY

Basic features of Magnetic Resonance Imaging(MRI) and its applications in Dentistry

Delantoni A.


The aim of the present study is to mention the basic featuresof Magnetic Resonance Imaging (MRI) and its applicationsin the maxillofacial region, and to present the main featurethe general dentist should know in daily practiceThe last few years imaging modalities of the maxillofacialregion have evolved significantly. Those imaging modalitiesinclude Magnetic Resonance Imaging which has becomeas a technique the most frequently applicable to a numberof pathoses of the region.The major advantage of the technique is the excellentimaging of the soft tissues of the area without giving radiationto the patient. This ability to clearly visualize the soft tissuesis not available to any other imaging techniques. The major applications of MRI in the maxillofacial regionare discussed. They include the visualization of thetemporomandibular joint and its structures, the visualizationof salivary gland pathoses and tumor imaging. Theseapplications are presented and discussed.

Key words: Magnetic resonance imaging; dental applications

BIB§IO°PAºIA1. Gray CF, Redpath TW, Smith FW, Staff RT: Advanced

imaging: magnetic resonance imaging in implant dentistry.Clin Oral Impants Res 2003; 14:18-27.

2. AÁÁÂÏfiÔ˘ÏÔ˜ A, ™˘ÚfiÔ˘ÏÔ˜ N, TÛÈ¯Ï¿ÎË˜ K: ™‡Á¯ÚÔÓË™ÙÔÌ·ÙÈÎ‹ Î·È °Ó·ıÔÚÔÛˆÈÎ‹ ¢È·ÁÓˆÛÙÈÎ‹ Î·È AÎÙÈÓÔÏÔ-Á›·. I·ÙÚÈÎ¤˜ ÂÎ‰fiÛÂÈ˜ §›ÙÛ·˜. Aı‹Ó·. 2001.

3. ¢ËÌËÙÚÈ¿‰Ë˜ A: AÂÈÎÔÓÈÛÙÈÎ‹ ‰È·ÁÓˆÛÙÈÎ‹: Ù· ‚·ÛÈÎ¿ Î·ÈÙ· ıÂÌÂÏÈÒ‰Ë. I·ÙÚÈÎ¤˜ ÂÎ‰fiÛÂÈ˜ ™ÈÒÎË˜. £ÂÛÛ·ÏÔÓ›ÎË.2004.

4. Runge VM, Patel MC, Baumann SS, Simonetta AB, PonzoJA, Lesley WS, Calderwood GW, Naul LG: T1 weightedimaging of the brain at 3 tesla using a 2- dimentional spoiledgradient echo technique. Invest Radiol 2006; 41:68-75.

5. Li QY, Zhang SX, Liu ZJ, Tan LW,Qiu MG, Li K, et al: The pre-styloidcompartment of theparapharyngeal space: a three-dimentional digitized modelbased on the Chinese VisibleHuman. Surg Radiol Anat 2004;26:411-6.

6. Gray CF, Redpath TW, Smith FW:Low field magnetic resonanceimaging for implant denstistry.Dentomaxillofac Radiol 1998;27:225-9.

55

∞Ó·ÛÎfiËÛË

T2 ÙÔÌ¤˜ fiÔ˘ ‰È·Ê·›ÓÔÓÙ·È Î·Ï‡ÙÂÚ· Ù· fiÚÈ· ÙÔ˘ fiÁÎÔ˘

EÈÎ. 5: T1 ÙÔÌ¤˜ ÚÈÓ Î·È ÌÂÙ¿ ÙË ¯Ú‹ÛË ÛÎÈ·ÁÚ·ÊÈÎÔ‡ ˘ÁÚÔ‡

¶›Ó·Î·˜

¶§EONEKTHMATA MEIONEKTHMATA

O ·ÛıÂÓ‹˜ ‰Â Ï·Ì‚¿ÓÂÈ ·ÎÙÈÓÔ‚ÔÏ›· Y„ËÏfi ÎfiÛÙÔ˜

Y„ËÏ‹ ‰È·ÊÔÚÔÔ›ËÛË ‰ÔÌÒÓ MÂÁ¿ÏÔ˜ ¯ÚfiÓÔ˜ ÂÍ¤Ù·ÛË˜

¢˘Ó·ÙfiÙËÙ· ÂÂÍÂÚÁ·Û›· ÂÈÎfiÓ·˜ Y„ËÏ‹ Î·Ù¿ÚÙÈÛË ÙÔ˘ ÚÔÛˆÈÎÔ‡

§‹„Ë ÔÏÏ·ÏÒÓ ·ÎÔÏÔ˘ıÈÒÓ AÓÙ¤Ó‰ÂÈÍË: ·ÛıÂÓÂ›˜ ÌÂ ÚfiÛÊ·ÙÂ˜ ÌÂÙ·ÏÏÈÎ¤˜ ÚÔı¤ÛÂÈ˜ ‹ Î·Ú‰È·ÎÔ‡˜ ‚ËÌ·ÙÔ‰fiÙÂ˜



∞Ó·ÛÎfiËÛË

7. McRobbie DW, Moore EA, Graves MJ, Prince MR: MRI: frompicture to proton. Cambridge University Press. 2003

8. White SC, Pharoah JM: Oral Radiology. Principles andInterpretation. St. Louis. Mosby. 2000.

9. Kaplan PA, Tu HK, Williams SM, Lydiatt DD: The normaltemporomandibular joint: MR and arthrographic correlation.Radiology 1987; 165 1:177-8.

10. Katzberg RW, Westesson PL, Tallents RH, Anderson R,Kurita K, Manzione JV Jr, Totterman S: Temporomandibularjoint: MR assessment of rotational and sideways diskdisplacements. Radiology 1988; 169 3:741-8.

11. Melchiorre DA, Calderazzi S, Maddali Bongi, Cristofani R,Bazzichi L, Eligi C, Maresca M, Ciompi M: A comparison ofultrasonography and magnetic resonance imaging in theevaluation of temporomandibular joint involvement inrheumatoid arthritis and psoriatic arthritis. Rheumatology(Oxford) 2003; 42 5:673-6.

12. Larheim TA, Westesson PL, Sano T: MR grading oftemporomandibular joint fluid: association with diskdisplacement categories, condyle marrow abnormalitiesand pain. Int J Oral Maxillofac Surg 2001; Apr 30(2):104-12.

13. van den Akker HP: Diagnostic imaging in salivary glanddisease. Oral Surg Oral Med Oral Pathol 1988 Nov;66(5):625-37. Review.

14. Curtin HD: Assessment of salivary gland pathology.Otolaryngol Clin North Am. 1988 Aug; 21(3):547-73. Review.

15. Mandelblatt SM, Braun IF, Davis PC, Fry SM, Jacobs LH,Hoffman JC Jr: Parotid masses: MR imaging.Radiology.1987 May; 163(2):411-4.

16. Tabor EK, Curtin HD: MR of the salivary glands. Radiol ClinNorth Am 1989 Mar; 27(2):379-92. Review.

17. Lenz M, Greess H, Baum U, Dobritz M, Kersting- SommerhoffB: Oropharynx, oral cavity, floor of the mouth: CT and MRI.European Journal of Radiology 2000; 33:203-215.

18. Lufkin RB, Wortham DG, Dietrich RB, Hoover LA, LarssonSG, Kangarloo H, et al: Tongue and oropharynx: findings on

MR imaging. Radiology 1986; 161:69-75.19. Nathanson A, Aegren K, Bioerklund A, Lind MG, Andreason

L, Anniko M, et al: Evaluation of some prognostic factors insmall squamous cell carcinoma of the mobile tongue: amulticenter study in Sweden. Head Neck 1989; 11:387-392.

20. Fukano H, Matsuura H, Hasegawa Y, Nakamura S: Depth ofinvasion as a predictive factor for cervical lymph nodemetastasis in tongue carcinoma. Head Neck 1997; 19:205-210.

21. Byers RM, El-Naggar AK, Lee Y, Rao B, Fornage B, TerryNHA, et al: Can we detect or predict the presence of occultnodal metastases in patients with squamous cell carcinomaof the oral tongue? Head Neck 1998; 20:138-144.

22. Asakage T, Yokose T, Mukai K, Tsugane S, Tsubono Y, AsaiM, et al: Tumor thickness predicts cervical metastasis inpatients with stage I/II carcinoma of the tongue. Cancer1998; 82:1443-1448.

23. Sigal R, Zagdanski AM, Schwaab G, et al: CT and MRimaging of squamous cell carcinoma of the tongue and floorof the mouth. RadioGraphics 1996;16:787-810.

24. Crawford S, Harnsberger H, Lufkin R, Hanafee W: The role ofgadolinium-DTPA in the evaluation of extracranial head andneck mass lesions. Radiol Clin North Am 1989; 27:219-42.

25. Phillips C, Gay S, Newton R, Levine P: Gadolinium-enhanced MRI of tumors of the head and neck. Head Neck1990; 12:308-15.

26. Vogl T, Dresel S, Juergens M, Assal J, Lissner J: Mr imagingwith gd-dtpa in lesions of the head and neck. J Otolaryngol1993; 22:220-30.

27. Modder U, Lenz M, Steinbrich W: MRI of facial skeleton andparapharyngeal space. Eur J Radiol 1987; 7:6-10.

28. Castelijns JA, van den Brekel MW: Magnetic resonanceimaging evaluation of extracranial head and neck tumors.Magn Reson Q 1993; 9:113-28.

¢ÈÂ‡ı˘ÓÛË ÁÈ· ÂÈÎÔÈÓˆÓ›·:AÓÙÈÁfiÓË ¢ÂÏ·ÓÙÒÓËe-mail: [email protected]

EI™A°ø°HMÂÙÂÌÊ‡ÙÂ˘ÛË ‰ÔÓÙÈÔ‡ (tooth transplantation) Â›Ó·È Ë ÌÂ-Ù·ÊÔÚ¿ ÙÔ˘ ‰ÔÓÙÈÔ‡ ·fi ÙËÓ ·Ú¯ÈÎ‹ ÙÔ˘ ı¤ÛË ÛÂ ‰È·ÊÔ-ÚÂÙÈÎ‹. ¶ÚfiÎÂÈÙ·È ‰ËÏ·‰‹ ÁÈ· ÌÂÙ·ÌfiÛ¯Â˘ÛË. ¢È·ÎÚ›ÓÂ-Ù·È ÛÂ ·˘ÙÔÁÂÓ‹ fiÔ˘ Ë ‰fiÙÚÈ· Î·È Ë ‰¤ÎÙÚÈ· ı¤ÛË ‚Ú›-ÛÎÔÓÙ·È ÛÙÔ ›‰ÈÔ ¿ÙÔÌÔ (·˘ÙÔÌÂÙ·ÌfiÛ¯Â˘ÛË), ÛÂ ÔÌÔÁÂ-Ó‹ fiÔ˘ Á›ÓÂÙ·È ÌÂÙ·ÊÔÚ¿ ‰ÔÓÙÈÔ‡ ·fi ¿ÙÔÌÔ ÛÂ ¿ÙÔÌÔÙÔ˘ ›‰ÈÔ˘ Â›‰Ô˘˜ Î·È ÛÂ ÂÙÂÚÔÁÂÓ‹ fiÙ·Ó ¤¯Ô˘ÌÂ ÌÂÙ·Ìfi-Û¯Â˘ÛË ‰ÔÓÙÈÔ‡ ÌÂÙ·Í‡ ·ÙfiÌˆÓ ‰È·ÊÔÚÂÙÈÎÒÓ ÂÈ‰ÒÓ1,2.°›ÓÂÙ·È ‰È·¯ˆÚÈÛÌfi˜ ÙÔ˘ fiÚÔ˘ ÌÂÙÂÌÊ‡ÙÂ˘ÛË ·fi ÙÔÓfiÚÔ Â·ÓÂÌÊ‡ÙÂ˘ÛË ‹ ·Ó·Ê‡ÙÂ˘ÛË ‰ÔÓÙÈÔ‡ (toothreimplantation), Î·ıÒ˜ Ô ‰Â‡ÙÂÚÔ˜ Â›Ó·È Ë Â·Ó·ÙÔÔ-

ı¤ÙËÛË ÙÔ˘ ‰ÔÓÙÈÔ‡ ÛÙÔ ›‰ÈÔ Ê·ÙÓ›Ô ·fi ÙÔ ÔÔ›Ô Â›¯ÂÚÔËÁÔ˘Ì¤Óˆ˜ ÂÎÁÔÌÊˆıÂ› ˆ˜ ·ÔÙ¤ÏÂÛÌ· ÙÚ·‡Ì·-ÙÔ˜1,2.H ÌÂÙÂÌÊ‡ÙÂ˘ÛË ‰ÔÓÙÈÒÓ Á›ÓÂÙ·È Â‰Ò Î·È ÔÏÏ¿ ¯ÚfiÓÈ··ÏÏ¿ ÌÂ ÔÈÎ›Ï· ÔÛÔÛÙ¿ ÂÈÙ˘¯›·˜. °È· ÙÔ ÏfiÁÔ ·˘ÙfiÛ¿ÓÈ· ÚÔÙÂ›ÓÂÙ·È ̂ ˜ Î·Ù¿ÏÏËÏÔ Û¯¤‰ÈÔ ıÂÚ·Â›·˜ Î·ÈÈ‰È·›ÙÂÚ· ÌÂÙ¿ ÙËÓ Û˘ÓÂ¯‹ ·Ó¿Ù˘ÍË ÙˆÓ ÔÛÙÂÔÂÓÛˆÌ·-ÙÔ‡ÌÂÓˆÓ Ô‰ÔÓÙÈÎÒÓ ÂÌÊ˘ÙÂ˘Ì¿ÙˆÓ. MÂ ÙËÓ ÂÊ·ÚÌÔÁ‹fiÌˆ˜ Î·Ù¿ÏÏËÏÔ˘ ÚˆÙÔÎfiÏÏÔ˘ ·fi ÙÔÓ ıÂÚ¿ÔÓÙ· Ô-‰ÔÓÙ›·ÙÚÔ Â›Ó·È ‰˘Ó·Ùfi Ó· ·˘ÍËıÔ‡Ó ÂÓÙ˘ˆÛÈ·Î¿ Ù·ÔÛÔÛÙ¿ ÂÈÙ˘¯›·˜ ÙË˜ ÌÂÙÂÌÊ‡ÙÂ˘ÛË˜ ¤ÙÛÈ ÒÛÙÂ ·˘Ù‹Ó· ·ÔÙÂÏÂ› ·ÍÈfiÏÔÁË ıÂÚ·Â˘ÙÈÎ‹ ÂÈÏÔÁ‹.™ÎÔfi˜ ÙË˜ ·ÚÔ‡Û·˜ ÌÂÏ¤ÙË˜ Â›Ó·È Ë ·ÚÔ˘Û›·ÛË ÙÔ˘ÚˆÙÔÎfiÏÏÔ˘ ·˘ÙÔ‡ Ì¤Û· ·fi ÙËÓ ·Ó·ÛÎfiËÛË ÙË˜Û¯ÂÙÈÎ‹˜ ‚È‚ÏÈÔÁÚ·Ê›·˜, Î·ıÒ˜ Î·È ·ÚÔ˘Û›·ÛË ÛÂÈÚ¿˜4 ÂÚÈÙÒÛÂˆÓ ÌÂÙÂÌÊ‡ÙÂ˘ÛË˜ ‰ÔÓÙÈÒÓ.

EN¢EI•EI™ METEMºYTEY™H™H ÛËÌ·ÓÙÈÎfiÙÂÚË ıÂÚ·Â˘ÙÈÎ‹ ÂÈÏÔÁ‹ ·ÓÙ› ÙË˜ ÌÂÙÂÌ-Ê‡ÙÂ˘ÛË˜ Â›Ó·È Ë ÙÔÔı¤ÙËÛË ÔÛÙÂÔÂÓÛˆÌ·ÙÔ‡ÌÂÓÔ˘ÂÌÊ˘ÙÂ‡Ì·ÙÔ˜. H ÌÂÙÂÌÊ‡ÙÂ˘ÛË ˆÛÙfiÛÔ ¤¯ÂÈ È‰È·›ÙÂ-ÚÂ˜ ÂÓ‰Â›ÍÂÈ˜ Î·È ÏÂÔÓÂÎÙ‹Ì·Ù·. ™Â ·Ó·Ù˘ÛÛfiÌÂÓÂ˜

AÓ·ÛÎfiËÛË Î·È ¶·ÚÔ˘Û›·ÛË EÓ‰È·ÊÂÚÔ˘ÛÒÓ ¶ÂÚÈÙÒÛÂˆÓ

MÂÙÂÌÊ‡ÙÂ˘ÛË ‰ÔÓÙÈÒÓ°ÚËÁfiÚÈÔ˜ BÂÓ¤ÙË˜1, ¶¿ÚÈ˜-°ÂÒÚÁÈÔ˜ §ÈÔÎ¿ÙË˜2, ºÒÙÈÔ˜ K·ÙÛÈÎ¿ÓË˜3

MÂÙÂÌÊ‡ÙÂ˘ÛË ‰ÔÓÙÈÔ‡ Â›Ó·È Ë ¯ÂÈÚÔ˘ÚÁÈÎ‹ ÌÂÙ·ÊÔÚ¿ ÙÔ˘ ‰ÔÓÙÈÔ‡ ·fi ÙËÓ ·Ú¯ÈÎ‹ ÙÔ˘ ı¤ÛË ÛÂ‰È·ÊÔÚÂÙÈÎ‹. ŸÙ·Ó Ë ‰fiÙÚÈ· Î·È Ë ‰¤ÎÙÚÈ· ı¤ÛË ‚Ú›ÛÎÔÓÙ·È ÛÙÔ ÛÙfiÌ· ÙÔ˘ ›‰ÈÔ˘ ·ÛıÂÓÔ‡˜ ÙfiÙÂÔÓÔÌ¿˙ÂÙ·È ·˘ÙÔÁÂÓ‹˜ Î·È Â›Ó·È ·˘Ù‹ Ë Î·ÙËÁÔÚ›· ÌÂÙÂÌÊ‡ÙÂ˘ÛË˜ Ô˘ ı· Ì·˜ ··Û¯ÔÏ‹ÛÂÈ.AÔÙÂÏÂ› Ì›· Ì¤ıÔ‰Ô ÌÂ ÔÈÎ›Ï· ÔÛÔÛÙ¿ ÂÈÙ˘¯›·˜ ‹ ÔÔ›· ÌÔÚÂ› Ó· ·ÔÙÂÏ¤ÛÂÈ Èı·Ófi Û¯¤-‰ÈÔ ıÂÚ·Â›·˜ Î·ıÒ˜ ¤¯ÂÈ È‰È·›ÙÂÚÂ˜ ÂÓ‰Â›ÍÂÈ˜ Î·È ·ÓÙÂÓ‰Â›ÍÂÈ˜, ÏÂÔÓÂÎÙ‹Ì·Ù· Î·È ÌÂÈÔÓÂÎÙ‹-Ì·Ù·. ™ÙËÓ ·Ó·ÛÎfiËÛË ·˘Ù‹ ·ÚÔ˘ÛÈ¿˙ÔÓÙ·È ÔÈ ÂÓ‰Â›ÍÂÈ˜, Ë ÚÔÔÙÈÎ¤˜ Ù· ÔÊ¤ÏË ·ÏÏ¿ Î·È Ù· ÌÂÈÔ-ÓÂÎÙ‹Ì·Ù· ÙË˜ ÌÂÙÂÌÊ‡ÙÂ˘ÛË˜ Î·ıÒ˜ Î·È ÔÈ ·Ú¿ÁÔÓÙÂ˜ Ô˘ ·›˙Ô˘Ó Î‡ÚÈÔ ÚfiÏÔ ÛÙËÓ ÂÍ¤ÏÈÍËÙË˜ ‰È·‰ÈÎ·Û›·˜. AÓ·Ï‡ÔÓÙ·È, Â›ÛË˜, ÔÈ Î‡ÚÈÔÈ ‚ÈÔÏÔÁÈÎÔ› ÌË¯·ÓÈÛÌÔ› Ô˘ ÂÓÂÚÁÔÔÈÔ‡ÓÙ·È Î·-Ù¿ ÙË ÌÂÙÂÌÊ‡ÙÂ˘ÛË Î·È Â›Ó·È fiÛÔÈ ·ÊÔÚÔ‡Ó ÙËÓ ÂÔ‡ÏˆÛË ÂÓfi˜ ÙÚ·‡Ì·ÙÔ˜. OÈ ÌË¯·ÓÈÛÌÔ› ·˘-ÙÔ› ˘ÚÔ‰ÔÙÔ‡Ó Î·È ÙÈ˜ ‰È¿ÊÔÚÂ˜ ÂÈÏÔÎ¤˜ Ô˘ Â›Ó·È ‰˘Ó·Ùfi Ó· ·ÚÔ˘ÛÈ·ÛÙÔ‡Ó ÌÂ Î˘Ú›·Ú¯ËÙËÓ ·ÔÚÚfiÊËÛË ÙˆÓ Ô‰ÔÓÙÈÎÒÓ ÈÛÙÒÓ. AÎfiÌË, ·ÚÔ˘ÛÈ¿˙ÂÙ·È ÛÂÈÚ¿ ÌÂ Ù¤ÛÛÂÚ· ÂÚÈÛÙ·ÙÈÎ¿ÌÂÙÂÌÊ‡ÙÂ˘ÛË˜ ‰ÔÓÙÈÔ‡. T¤ÏÔ˜, ·Ó·Ï‡ÔÓÙ·È ÔÈ Ô‰ËÁ›Â˜ Ô˘ Û˘ÛÙ‹ÓÂÙ·È Ó· ·ÎÔÏÔ˘ıÂ› Ô Ô‰ÔÓÙ›·-ÙÚÔ˜, ÌÂ ‚¿ÛË ÙË ÌÂÏ¤ÙË ÙË˜ Û‡Á¯ÚÔÓË˜ ‚È‚ÏÈÔÁÚ·Ê›·˜ ¿Óˆ ÛÙÔ ı¤Ì·, ÒÛÙÂ Ó· ·˘ÍËıÂ› Ë È-ı·ÓfiÙËÙ· ÂÈÙ˘¯ËÌ¤ÓË˜ ÌÂÙÂÌÊ‡ÙÂ˘ÛË˜.™˘ÌÂÚ·ÛÌ·ÙÈÎ¿, Ë ÌÂÙÂÌÊ‡ÙÂ˘ÛË ‰ÔÓÙÈÔ‡ Â›Ó·È Ì›· ÔÏ‡ÏÔÎË Î·È Â˘·›ÛıËÙË ‰È·‰ÈÎ·Û›· Î·Ù¿ÙËÓ ÔÔ›· fiÌˆ˜ Ô Ô‰ÔÓÙ›·ÙÚÔ˜ Â›Ó·È ‰˘Ó·Ùfi ÌÂ ÙËÓ ÂÊ·ÚÌÔÁ‹ ÙË˜ Î·Ù¿ÏÏËÏË˜ ÌÂıÔ‰ÔÏÔÁ›·˜ Ó·‚ÂÏÙÈÒÛÂÈ ÛËÌ·ÓÙÈÎ¿ ÙËÓ Èı·ÓfiÙËÙ· ÂÈÙ˘¯›·˜ Î·È Ó· ÂÚÈÔÚ›ÛÂÈ ÙËÓ ÂÌÊ¿ÓÈÛË ÂÈÏÔÎÒÓ ÂÍ·-ÛÊ·Ï›˙ÔÓÙ·˜ ÙËÓ ·Ú·ÌÔÓ‹ ÙˆÓ ÌÂÙÂÌÊ˘ÙÂ˘Ì¤ÓˆÓ ‰ÔÓÙÈÒÓ ÁÈ· ·ÚÎÂÙ¿ ¯ÚfiÓÈ· ÛÙÔ ÛÙfiÌ· ·Ú¤-¯ÔÓÙ·˜, ÙÂÏÈÎ¿, ÛÙÔÓ ·ÛıÂÓ‹ ÙÔ˘ ¤Ó· ·ÎfiÌË Û¯¤‰ÈÔ ıÂÚ·Â›·˜ ÌÂ ÔÏÏ¿ ÏÂÔÓÂÎÙ‹Ì·Ù·.


§¤ÍÂÈ˜ ÎÏÂÈ‰È¿: ÌÂÙÂÌÊ‡ÙÂ˘ÛË, ·ÓÙÈÎ·Ù·ÛÙ·ÙÈÎ‹ ·ÔÚÚfiÊËÛË,ÊÏÂÁÌÔÓÒ‰Ë˜ ·ÔÚÚfiÊËÛË, ·ÎÈÓËÙÔÔ›ËÛË ‰Ô-ÓÙÈÔ‡

1 E›ÎÔ˘ÚÔ˜ K·ıËÁËÙ‹˜ O‰/Î‹˜ ™¯ÔÏ‹˜ A.¶.£.2 XÂÈÚÔ˘ÚÁfi˜ O‰ÔÓÙ›·ÙÚÔ˜3 ¶ÚÔÙ˘¯È·Îfi˜ ºÔÈÙËÙ‹˜ O‰/Î‹˜ ™¯ÔÏ‹˜ A.¶.£.

ÿ‰Ú˘Ì· ÚÔ¤ÏÂ˘ÛË˜: O‰ÔÓÙÈ·ÙÚÈÎ‹ ™¯ÔÏ‹ AÚÈÛÙÔÙ¤ÏÂÈÔ˘ ¶·ÓÂÈ-ÛÙ‹ÌÈÔ˘ £ÂÛÛ·ÏÔÓ›ÎË˜

57

ÁÓ¿ıÔ˘˜ ÓÂ·ÚÒÓ ·ÛıÂÓÒÓ ÙÔ ÌÂÙÂÌÊ˘ÙÂ˘Ì¤ÓÔ ‰fiÓÙÈÌÔÚÂ› Ó· ·Ó·Ù‡ÛÛÂÙ·È ÂÓÂÚÁ¿ Ì·˙› ÌÂ ÙË ÁÓ¿ıÔ ÙÔ˘ ·-ÛıÂÓ‹ Î·È Ó· ·Ó·Ù¤ÏÏÂÈ ÛÂ ·ÚÌÔÓ›· ÌÂ Ù· ˘fiÏÔÈ· ‰fi-ÓÙÈ·3. E›ÛË˜, ÌÂ ÙËÓ ÙÔÔı¤ÙËÛË ÔÛÙÂÔÂÓÛˆÌ·ÙÔ‡ÌÂ-ÓÔ˘ ÂÌÊ˘ÙÂ‡Ì·ÙÔ˜ ¤¯ÂÈ ·Ô‰ÂÈ¯ıÂ› ˆ˜ Ô ·ÛıÂÓ‹˜ ̄ ¿ÓÂÈÌ›· ÔÛfiÙËÙ· ÔÛÙÔ‡ ÂÙËÛ›ˆ˜. AÓÙ›ıÂÙ·, ÌÂ ÙËÓ ÌÂÙÂÌÊ‡-ÙÂ˘ÛË ‰ÔÓÙÈÔ‡ ÌÔÚÂ› Ó· ‰È·ÙËÚÂ›Ù·È ÙÔ ÔÛÙfi ‹ ·ÎfiÌËÎ·È Ó· ·Ú¿ÁÂÙ·È Ó¤Ô Î·Ù¿ ÙË ‰È·‰ÈÎ·Û›· ÙË˜ ÏÂÈÙÔ˘ÚÁÈ-Î‹˜ ·Ó·ÙÔÏ‹˜3. T¤ÏÔ˜, Ë ÌÂÙÂÌÊ‡ÙÂ˘ÛË Â›Ó·È Ì›· Î·Ù¿ÔÏ‡ ÊıËÓfiÙÂÚË ‰È·‰ÈÎ·Û›· ÁÈ· ÙÔÓ ·ÛıÂÓ‹ ·fi ÙËÓ ÙÔ-Ôı¤ÙËÛË ÂÌÊ˘ÙÂ‡Ì·ÙÔ˜.

KÏÈÓÈÎ¤˜ Î·Ù·ÛÙ¿ÛÂÈ˜ ÛÙÈ˜ ÔÔ›Â˜ Ë ÌÂÙÂÌÊ‡ÙÂ˘ÛË ‰Ô-ÓÙÈÔ‡ ¤¯ÂÈ ¤Ó‰ÂÈÍË Â›Ó·È4:

ñ TÚ·‡Ì· ÌÂ ‰˘ÛÌÂÓÂ›˜ Û˘Óı‹ÎÂ˜ ÁÈ· Â·ÓÂÌÊ‡ÙÂ˘-ÛË. H Ê·ÙÓÈ·Î‹ ·fiÊ˘ÛË Î·È ÔÈ ÙÔÌÂ›˜ ÙË˜ ¿Óˆ ÁÓ¿-ıÔ˘ Â›Ó·È Ù· ‰fiÓÙÈ· Ô˘ ÈÔ Û˘¯Ó¿ ÂÌÏ¤ÎÔÓÙ·È ÛÂ Ù¤-ÙÔÈ· ÙÚ·‡Ì·Ù·. H ÌÂÙÂÌÊ‡ÙÂ˘ÛË ÙÔ˘ ‰ÔÓÙÈÔ‡ ÛÂ ı¤ÛËÌÂÚÈÎ‹˜ Óˆ‰fiÙËÙ·˜ Â›Ó·È ÌÈ· ÂÓ·ÏÏ·ÎÙÈÎ‹ ÙË˜ ÂÍ·Áˆ-Á‹˜ Ï‡ÛË.ñ ™˘ÓˆÛÙÈÛÌ¤Ó· ‹ ¤ÎÙÔ· ‰fiÓÙÈ·, fiÔ˘ Ë ÌÂÙÂÌÊ‡-ÙÂ˘ÛË ÛÙË ÛˆÛÙ‹ ı¤ÛË ÛÙÔ ÙfiÍÔ Â›Ó·È ·Ï‹, ÊıËÓ‹Î·È ÁÚ‹ÁÔÚË Ï‡ÛË ÁÈ· ÂÓ‹ÏÈÎÂ˜ Î˘Ú›ˆ˜ ·ÛıÂÓÂ›˜ Ô˘·ÔÚÚ›ÙÔ˘Ó ÙËÓ ÔÚıÔ‰ÔÓÙÈÎ‹ ıÂÚ·Â›·.ñ ŒÁÎÏÂÈÛÙ· ‰fiÓÙÈ· ÛÂ ı¤ÛË fiÔ˘ Ë ¯ÂÈÚÔ˘ÚÁÈÎ‹ ·-ÔÎ¿Ï˘„Ë Î·È Ë ÔÚıÔ‰ÔÓÙÈÎ‹ ÌÂÙ·Î›ÓËÛË Â›Ó·È ÔÏ‡‰‡ÛÎÔÏË ‹ ¤¯ÂÈ ·ÔÙ‡¯ÂÈ.ñ AÓÙÈÎ·Ù¿ÛÙ·ÛË Û˘ÁÁÂÓÒ˜ ÂÏÏÂÈfiÓÙˆÓ ‰ÔÓÙÈÒÓ ÛÂÓÂ·ÚÔ‡˜ ·ÛıÂÓÂ›˜ ÂÈ‰ÈÎ¿ fiÙ·Ó Ë ÔÚıÔ‰ÔÓÙÈÎ‹ ıÂÚ·-Â›· ÚÔ‚Ï¤ÂÈ ÙËÓ ÂÍ·ÁˆÁ‹ ¿ÏÏˆÓ ‰ÔÓÙÈÒÓ.ñ AÓÙÈÎ·Ù¿ÛÙ·ÛË ‰ÔÓÙÈÒÓ ÌÂ ÊÙˆ¯‹ ÚfiÁÓˆÛË ÏfiÁˆÚÔÛ‚ÔÏ‹˜ ·fi ÙÂÚË‰fiÓ· ‹ ÂÚÈÔ‰ÔÓÙ›ÙÈ‰·, Û˘Ó‹-ıˆ˜ ÚÒÙˆÓ ÁÔÌÊ›ˆÓ, ÌÂ ÙÚ›ÙÔ˘˜ ÁÔÌÊ›Ô˘˜ ñ AÔÎ·Ù¿ÛÙ·ÛË ·ÛıÂÓÒÓ ÌÂ Û¯ÈÛÙ›Â˜.

BIO§O°IKO™ MHXANI™MO™ KATA THN METEMºYTEY™HK·ıÔÚÈÛÙÈÎfi˜ ‚ÈÔÏÔÁÈÎfi˜ ÌË¯·ÓÈÛÌfi˜ ÛÙËÓ ÌÂÙÂÌÊ‡ÙÂ˘-ÛË ‰ÔÓÙÈÔ‡ Â›Ó·È Ë ·ÔÎ·Ù¿ÛÙ·ÛË ÙÚ·‡Ì·ÙÔ˜. TÚ·‡Ì·˘Ê›ÛÙ·ÓÙ·È ÔÈ Ô‰ÔÓÙÈÎÔ› ÛÎÏËÚÔ› ÈÛÙÔ›, ÙÔ Ê·ÙÓÈ·Îfi ÔÛÙfiÎ·È Ù· Ô‡Ï·, ·ÏÏ¿ Î˘Ú›ˆ˜ Ô ÔÏÊÈÎfi˜ ÈÛÙfi˜ ÙÔ˘ ÔÔ›Ô˘Ù· ·ÁÁÂ›· Î·È Ù· ÓÂ‡Ú· ·ÔÎfiÙÔÓÙ·È ÛÙÔ ÛËÌÂ›Ô ÙÔ˘ ·-ÎÚÔÚÚÈ˙ÈÎÔ‡ ÙÚ‹Ì·ÙÔ˜, Î·ıÒ˜ Î·È Ô ÂÚÈÔ‰ÔÓÙÈÎfi˜ Û‡Ó-‰ÂÛÌÔ˜ (¶™). MÂÙ¿ ÙËÓ ÌÂÙÂÌÊ‡ÙÂ˘ÛË ÙÔ˘ ‰ÔÓÙÈÔ‡ ÍÂÎÈ-Ó¿ Ë ‰È·‰ÈÎ·Û›· ÂÔ‡ÏˆÛË˜, Î·Ù¿ ÙËÓ ÔÔ›· Î‡ÙÙ·Ú· ÌÂÎÏ·ÛÙÈÎ¤˜ È‰ÈfiÙËÙÂ˜ Ê·ÁÔÎ˘ÙÙ·ÚÒÓÔ˘Ó ÙÔ˘˜ Î·ÙÂ-ÛÙÚ·ÌÌ¤ÓÔ˘˜ ÈÛÙÔ‡˜, ÌÂÙ·Í‡ ·˘ÙÒÓ ÙËÓ ÔÛÙÂ˝ÓË Î·È ÙËÓÔ‰ÔÓÙ›ÓË. ŸÙ·Ó Ë Î·Ù·ÛÙÚÔÊ‹ Â›Ó·È ÌÈÎÚ‹˜ ¤ÎÙ·ÛË˜, ÙfiÙÂ ÔÈ ÁÂÈÙÔ-ÓÈÎÔ› ÔÛÙÂÈÓÔ‚Ï¿ÛÙÂ˜ Â·Ó·ÔÈÎ›˙Ô˘Ó ÙËÓ ·ÔÁ˘ÌÓˆÌ¤-ÓË ÂÈÊ¿ÓÂÈ· ÙË˜ Ú›˙·˜ Î·È ÂÓ·Ôı¤ÙÔ˘Ó ÔÛÙÂ˝ÓË ÛÙËÓ Ô-Ô›· Î·Ù·Ï‹ÁÔ˘Ó ÔÈ Ó¤Â˜ ÂÚÈÔ‰ÔÓÙÈÎ¤˜ ›ÓÂ˜ Ô˘ Û¯ËÌ·-Ù›˙ÔÓÙ·È Î·Ù¿ ÙË ‰È¿ÚÎÂÈ· ÙË˜ ÂÔ‡ÏˆÛË˜. A˘Ù‹ Ë ‰È·‰È-Î·Û›· ÔÓÔÌ¿˙ÂÙ·È ÂÈÊ·ÓÂÈ·Î‹ ·ÔÚÚfiÊËÛË ‹ ·ÏÏÈÒ˜ÏÂÈÙÔ˘ÚÁÈÎ‹ ÂÔ‡ÏˆÛË (functional healing) Î·Ù¿ ÙËÓ Ô-Ô›· ÔÈ ÓÂÎÚˆÌ¤ÓÔÈ ÈÛÙÔ› ·ÓÙÈÎ·ı›ÛÙ·ÓÙ·È ÌÂ fiÌÔÈÔ˘˜ Î·ÈË ÌÂÙ¤ÂÈÙ· ÏÂÈÙÔ˘ÚÁ›· Â·Ó¤Ú¯ÂÙ·È ÛÙÔ Ê˘ÛÈÔÏÔÁÈÎfi5. MÂÁ·Ï‡ÙÂÚË˜ ¤ÎÙ·ÛË˜ ·ÔÁ˘ÌÓˆÌ¤ÓÂ˜ ÂÈÊ¿ÓÂÈÂ˜ ÙË˜

Ú›˙·˜ Â›Ó·È Èı·Ófi Ó· ÌËÓ Î·Ï˘ÊıÔ‡Ó ÂÁÎ·›Úˆ˜ ·fi Ô-ÛÙÂÈÓÔ‚Ï¿ÛÙÂ˜. ™Â ·˘Ù‹ ÙËÓ ÂÚ›ÙˆÛË ÙÔ ÌÂÙÂÌÊ˘ÙÂ˘-Ì¤ÓÔ ‰fiÓÙÈ ÎÈÓ‰˘ÓÂ‡ÂÈ ·fi ÙÈ˜ ‰‡Ô Û˘¯ÓfiÙÂÚÂ˜ ÂÈÏÔ-Î¤˜ Ô˘ Â›Ó·È Ë ·ÓÙÈÎ·Ù·ÛÙ·ÙÈÎ‹ ·ÔÚÚfiÊËÛË(replacement resorption) Î·È Ë ÊÏÂÁÌÔÓÒ‰Ë˜ ·ÔÚÚfi-ÊËÛË (inflammatory related resorption)5.K·Ù¿ ÙËÓ ·ÓÙÈÎ·Ù·ÛÙ·ÙÈÎ‹ ·ÔÚÚfiÊËÛË ÙÔ ÔÛÙfi ‚Ú›ÛÎÂ-Ù·È ÛÂ Â·Ê‹ ÌÂ ÙËÓ ÔÛÙÂ˝ÓË ÙË˜ Ú›˙·˜, Èı·ÓÒ˜ Û¯ËÌ·-Ù›˙ÔÓÙ·˜ ÎÔÈÏfiÙËÙÂ˜, Î·È Ì¤Ûˆ ÙË˜ Ê˘ÛÈÔÏÔÁÈÎ‹˜ ‰È·‰È-Î·Û›·˜ ÌÂÙ·Û¯ËÌ·ÙÈÛÌÔ‡ ÙÔ˘ ÔÛÙÔ‡ (bone remodeling)Ë ÔÛÙÂ˝ÓË Î·È Ë Ô‰ÔÓÙ›ÓË ·ÓÙÈÎ·ı›ÛÙ·ÓÙ·È ·fi ÔÛÙfi, ÂÓÒÔ ÂÚÈÔ‰ÔÓÙÈÎfi˜ Û‡Ó‰ÂÛÌÔ˜ ·Ô˘ÛÈ¿˙ÂÈ. ™Ù·‰È·Î¿ ÙÔ‰fiÓÙÈ Ô‰ËÁÂ›Ù·È ÛÂ ·ÁÎ‡ÏˆÛË (ankylosis) Ë ÔÔ›· ıÂˆ-ÚÂ›Ù·È Ì›· ·ÓÙÈÎ·Ù·ÛÙ·ÙÈÎ‹ ·ÔÚÚfiÊËÛË ‚Ú·‰Â›·˜ ÂÍ¤-ÏÈÍË˜5.H ÊÏÂÁÌÔÓÒ‰Ë˜ ·ÔÚÚfiÊËÛË Â›Ó·È ÙÔ ·ÔÙ¤ÏÂÛÌ· Ìfi-Ï˘ÓÛË˜ ÙË˜ ÂÚÈÔ‰ÔÓÙÈÎ‹˜ ÂÚÈÔ¯‹˜, ·fi Ù· ̆ ÔÏÂ›ÌÌ·-Ù· ÙÔ˘ ÓÂÎÚÔ‡ ÔÏÊÔ‡, Ô˘ ÂÍ¤Ú¯ÔÓÙ·È ·fi Ù· Â˘Ú¤· Ô-‰ÔÓÙÈÓÔÛˆÏËÓ¿ÚÈ· Â›ÙÂ ÏfiÁˆ ÙË˜ ·ÓˆÚÈÌfiÙËÙ·˜ ÙˆÓ ‰Ô-ÓÙÈÒÓ Â›ÙÂ ÏfiÁˆ ÙË˜ ÂÍˆÙÂÚÈÎ‹˜ ·ÔÚÚfiÊËÛË˜. H ÊÏÂÁ-ÌÔÓÒ‰Ë˜ ·ÔÚÚfiÊËÛË ÚÔÎ·ÏÂ› Ù·¯Â›· ·ÔÚÚfiÊËÛËÙÔ˘ Ê·ÙÓÈ·ÎÔ‡ ÔÛÙÔ‡ Î·È ÙˆÓ Ô‰ÔÓÙÈÎÒÓ ÛÎÏËÚÒÓ ÈÛÙÒÓÎ·È Û˘ÓÙËÚÂ›Ù·È ·fi ÙËÓ ·ÔÛ‡ÓıÂÛË ÙÔ˘ ÔÏÊÈÎÔ‡ È-ÛÙÔ‡5.

¶APA°ONTE™ OI O¶OIOI E¶HPEAZOYN THN E¶ITYXIA TH™ METEMºYTEY™H™OÈ ·Ú¿ÁÔÓÙÂ˜ ÔÈ ÔÔ›ÔÈ ı· ÂËÚÂ¿ÛÔ˘Ó ÙÔ ÙÂÏÈÎfi ·Ô-Ù¤ÏÂÛÌ· ÌÈ·˜ ÌÂÙÂÌÊ‡ÙÂ˘ÛË˜, Â¿Ó ‰ËÏ·‰‹ ı· ¤¯Ô˘ÌÂ Â-ÈÊ·ÓÂÈ·Î‹ ·ÔÚÚfiÊËÛË Î·È ÏÂÈÙÔ˘ÚÁÈÎ‹ ÂÔ‡ÏˆÛË, ·-ÓÙÈÎ·Ù·ÛÙ·ÙÈÎ‹ ‹ ÊÏÂÁÌÔÓÒ‰Ë ·ÔÚÚfiÊËÛË, Û¯ÂÙ›˙Ô-ÓÙ·È 1) ÌÂ ÙÔÓ ‚·ıÌfi Î·È ÙËÓ ¤ÎÙ·ÛË ÙÔ˘ ÙÚ·˘Ì·ÙÈÛÌÔ‡ÙˆÓ ÂÌÏÂÎfiÌÂÓˆÓ ÈÛÙÒÓ Î·È Î˘Ú›ˆ˜ ÙÔ˘ ÔÏÊÔ‡ Î·È ÙÔ˘ÂÚÈÔ‰ÔÓÙÈÎÔ‡ Û˘Ó‰¤ÛÌÔ˘, Î·È 2) ÌÂ ¯·Ú·ÎÙËÚÈÛÙÈÎ¿ÙÔ˘ ‰ÔÓÙÈÔ‡ fiˆ˜ Ë ‰È¿Ï·ÛË ÙË˜ Ú›˙·˜ Î·È Ë ÌfiÏ˘ÓÛËÙÔ˘ ÔÏÊÔ‡. EÈ‰ÈÎfiÙÂÚ·, Ë ¤ÎÙ·ÛË ÙÔ˘ ÙÚ·‡Ì·ÙÔ˜ ÂËÚÂ¿˙ÂÙ·È ·fi:

ñ TÔÓ ¯ÚfiÓÔ Ô˘ ÌÂÛÔÏ¿‚ËÛÂ Ì¤¯ÚÈ Ó· Â·Ó·ÙÔÔ-ıÂÙËıÂ› ÙÔ ‰fiÓÙÈ ÛÙÔ Ê·ÙÓ›Ôñ TÔ Ì¤ÛÔ ÛÙÔ ÔÔ›Ô ‰È·ÙËÚ‹ıËÎÂ ÙÔ ‰fiÓÙÈ ÛÂ ÂÚ›-ÙˆÛË ·Ú·ÙÂÙ·Ì¤ÓË˜ ÂÍˆÛÙÔÌ·ÙÈÎ‹˜ ·Ú·ÌÔÓ‹˜ñ TÔ ‚·ıÌfi ÌË¯·ÓÈÎ‹˜ Î¿ÎˆÛË˜ ÙˆÓ ÈÛÙÒÓ Î·Ù¿ ÙËÓ·Ê·›ÚÂÛË ÙÔ˘ ‰ÔÓÙÈÔ‡ ·fi ÙÔ Ê·ÙÓ›Ô Î·ıÒ˜ Î·È Î·Ù¿ÙË ‰È¿ÚÎÂÈ· ÙˆÓ ¯ÂÈÚÈÛÌÒÓ ÁÈ· ÙËÓ ÚÔÂÙÔÈÌ·Û›· Î·ÈÙËÓ Â·Ó·ÙÔÔı¤ÙËÛ‹ ÙÔ˘.

™Â Î¿ıÂ ·fiÂÈÚ· ÌÂÙÂÌÊ‡ÙÂ˘ÛË˜ ‰ÔÓÙÈÔ‡ Ô ıÂÚ¿ˆÓÎ·ÏÂ›Ù·È Ó· ··ÓÙ‹ÛÂÈ ÛÂ Û˘ÁÎÂÎÚÈÌ¤Ó· ÂÚˆÙ‹Ì·Ù· fi-ˆ˜:

ñ E¿Ó Î·È fiÙÂ ı· Á›ÓÂÈ ÂÓ‰Ô‰ÔÓÙÈÎ‹ ıÂÚ·Â›· (E£) ‹·ÎÚÔÚÚÈ˙ÂÎÙÔÌ‹ñ E¿Ó ı· ÚÔËÁËıÂ› ÂÂÍÂÚÁ·Û›· ÙË˜ ÂÍˆÙÂÚÈÎ‹˜ Â-ÈÊ¿ÓÂÈ·˜ ÙË˜ Ú›˙·˜ñ ¶ˆ˜ ı· Á›ÓÂÈ Ë ÚÔÂÙÔÈÌ·Û›· ÙË˜ ‰¤ÎÙÚÈ·˜ ı¤ÛË˜Î·È ÛÂ ÔÈ· ı¤ÛË ı· Á›ÓÂÈ Ë ÙÔÔı¤ÙËÛË ÙÔ˘ ‰ÔÓÙÈÔ‡ ñ E¿Ó, ÁÈ· fiÛÔ Î·È ÌÂ ÙÈ Ì¤ÛÔ ı· Á›ÓÂÈ Ó·ÚıËÎÔÔ›Ë-ÛË ÙÔ˘ Â·ÓÂÌÊ˘ÙÂ˘Ì¤ÓÔ˘ ‰ÔÓÙÈÔ‡ñ E¿Ó ı· Û˘ÓÙ·ÁÔÁÚ·ÊËıÂ› ·ÓÙÈ‚›ˆÛËñ MÂ ÔÈÔ ÙÚfiÔ ı· Á›ÓÂÙ·È Ô Ù·ÎÙÈÎfi˜ ¤ÏÂÁ¯Ô˜ ÙË˜ÔÚÂ›·˜ ÙÔ˘ ‰ÔÓÙÈÔ‡

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¶APOY™IA™H ¶EPI¶Tø™EøN¶ÂÚ›ÙˆÛË 1ËÕÚÚËÓ ·ÛıÂÓ‹˜ 22 ÂÙÒÓ ˘Ô‚Ï‹ıËÎÂ ÛÂ ¯ÂÈÚÔ˘ÚÁÈÎ‹ ·-ÔÎ¿Ï˘„Ë ÂÁÎÏÂ›ÛÙÔ˘ 13 Î·È ÚÔÛ¿ıÂÈ· ÔÚıÔ‰ÔÓÙÈÎ‹˜ÌÂÙ·Î›ÓËÛ‹˜ ÙÔ˘ ÛÙÔ ÊÚ·ÁÌfi. MÂÙ¿ ·fi ¤Ó· ¤ÙÔ˜ ‰ÈÂÎfi-Ë Ë ÔÚıÔ‰ÔÓÙÈÎ‹ ıÂÚ·Â›· ÁÈ·Ù› ‰ÂÓ Â›¯Â ·ÔÙ¤ÏÂÛÌ·(ÂÈÎ. 1·) Î·È ·ÔÊ·Û›ÛÙËÎÂ ÌÂÙÂÌÊ‡ÙÂ˘ÛË ÙÔ˘ ‰ÔÓÙÈÔ‡.A˘Ù‹ ¤ÁÈÓÂ ÌÂ Ù·˘Ùfi¯ÚÔÓË ÂÍˆÛÙÔÌ·ÙÈÎ‹ ÂÓ‰Ô‰ÔÓÙÈÎ‹ıÂÚ·Â›· (ÂÈÎ. 1‚). TÔ ÎÏÈÓÈÎfi Î·È ·ÎÙÈÓÔÏÔÁÈÎfi ·ÔÙ¤ÏÂ-ÛÌ· ÌÂÙ¿ ·fi ‰‡Ô ̄ ÚfiÓÈ· Ê·›ÓÂÙ·È ÛÙÈ˜ ÂÈÎ. 1Á, ‰. ¶·Ú·-ÙËÚÂ›Ù·È ·ÓÙÈÎ·Ù·ÛÙ·ÙÈÎ‹ ·ÔÚÚfiÊËÛË ÛÂ ÌÂÁ¿ÏÔ Ì¤-ÚÔ˜ ÙË˜ Ú›˙·˜ (‚¤ÏË) Ô˘ ÂÚÈÏ·Ì‚¿ÓÂÈ Î·È Ì¤ÚÔ˜ ÙÔ˘ÂÌÊÚ·ÎÙÈÎÔ‡ Ê˘Ú¿Ì·ÙÔ˜, ÂÓÒ Ô ÎÒÓÔ˜ ÁÔ˘Ù·¤ÚÎ·˜·Ú·Ì¤ÓÂÈ ¿ıÈÎÙÔ˜.

¶ÂÚ›ÙˆÛË 2ËAÛıÂÓ‹˜ 19 ÂÙÒÓ, ¿Ó‰Ú·˜, ˘Ô‚Ï‹ıËÎÂ ÛÂ ÂÍ·ÁˆÁ‹ Â-ÎÙfiÔ˘ 34 Î·È ÌÂÙÂÌÊ‡ÙÂ˘ÛË ÂÁÎÏÂ›ÛÙÔ˘ 33 (ÂÈÎ. 2·, ‚).™ÙÔ ‰fiÓÙÈ ‰ÂÓ ¤ÁÈÓÂ ¿ÌÂÛ· ÂÓ‰Ô‰ÔÓÙÈÎ‹ ıÂÚ·Â›·, ·ÏÏ¿ÌÂÙ¿ ·fi ¤Ó· 15Óı‹ÌÂÚÔ (ÂÈÎ. 2Á, ‰). H ı¤ÛË ÙÔ˘ ‰ÔÓÙÈÔ‡Î·È Ë ‰È·ÌfiÚÊˆÛË ÙÔ˘ Ì·ÛËÙÈÎÔ‡ ÂÈ¤‰Ô˘ Î·Ù¤ÛÙËÛÂ·Ó·fiÊÂ˘ÎÙË ÙË Û˘ÁÎÏÂÈÛÈ·Î‹ ÂÈ‚¿Ú˘ÓÛË ÙÔ˘ 33 (Î˘-ÓÔ‰ÔÓÙÈÎ‹ ÚÔÛÙ·Û›·, ÂÈÎ. 2Â). O ¤ÏÂÁ¯Ô˜ ÌÂÙ¿ ‰ÈÂÙ›· ·-ÔÎ¿Ï˘„Â ÌÈÎÚ‹ ·ÔÚÚfiÊËÛË ÛÙÔ ·ÎÚÔÚÚ›˙ÈÔ ÙÔ˘ 33,·Ú¿ ÙË ÛËÌ·ÓÙÈÎ‹ Û˘ÁÎÏÂÈÛÈ·Î‹ ÙÔ˘ ÂÈ‚¿Ú˘ÓÛË, ÂÍ·È-Ù›·˜ ÙË˜ ÔÔ›·˜ ‰È·ÙËÚ‹ıËÎÂ ÌÈ· ÛÙÔÈ¯ÂÈÒ‰Ë˜ Ó·ÚıËÎÔ-Ô›ËÛ‹ ÙÔ˘ ÌÂ ÙÔ ·Ú·ÎÂ›ÌÂÓÔ #32.

¶ÂÚ›ÙˆÛË 3Ë°˘Ó·›Î· 29 ÂÙÒÓ ÚÔÛ‹ÏıÂ ÁÈ· ÌÂÙÂÌÊ‡ÙÂ˘ÛË ˘ÂÎÊ˘-ı¤ÓÙÔ˜ 37 (ÂÈÎ. 3·), Ô˘ ‰ÂÓ ·ÓÙ·ÔÎÚ›ÓÔÓÙ·Ó ÛÂ Ì·ÎÚfi-¯ÚÔÓË ÔÚıÔ‰ÔÓÙÈÎ‹ ¤ÏÍË. H ˘¤ÎÊ˘ÛË ÙÔ˘ 37 ÔÊÂ›ÏÔ-ÓÙ·Ó ÛÂ ·ÓÒÌ·ÏË ¤ÁÎÏÂÈÛË ÙÔ˘ 38, Ô˘ ·Ê·ÈÚ¤ıËÎÂ ¯ÂÈ-ÚÔ˘ÚÁÈÎ¿ ÛÙËÓ ÚÔÛ¿ıÂÈ· Ó· ·Ó·Ù·¯ıÂ› ÔÚıÔ‰ÔÓÙÈÎ¿ Ë˘¤ÎÊ˘ÛË ÙÔ˘ 37. MÂÙ¿ ÙËÓ ·ÙÚ·˘Ì·ÙÈÎ‹ ÂÍ·ÁˆÁ‹ ÙÔ˘37, Ô˘ ¤ÁÈÓÂ ÌÂ ÙË ÌÂÁ·Ï‡ÙÂÚË ‰˘Ó·Ù‹ ÚÔÛÔ¯‹, ÒÛÙÂÓ· Û˘Ó·Ê·ÈÚÂıÂ› Î·È ÙÌ‹Ì· ÙÔ˘ ÂÚÈÔ‰ÔÓÙÈÎÔ‡ Û˘Ó‰¤-ÛÌÔ˘ (ÂÈÎ. 3‚), ¤ÁÈÓÂ ÂÓ‰Ô‰ÔÓÙÈÎ‹ ıÂÚ·Â›· Î·È ·ÎÚÔÚÚÈ-˙ÂÎÙÔÌ‹ ÂÍˆÛÙÔÌ·ÙÈÎ¿, ÂÓÒ Ë Ú›˙Â˜ ‚ÚÈÛÎfiÙ·Ó ‰È·ÚÎÒ˜ÛÂ ˘ÁÚfi Î·È ÈÛfiÙÔÓÔ ÂÚÈ‚¿ÏÔÓ (ÂÈÎ. 3Á). H ·ÎÈÓËÙÔÔ›Ë-ÛË ÙÔ˘ ‰ÔÓÙÈÔ‡ ÛÙË Ó¤· ı¤ÛË ÙÔ˘ ÛÙÔ ÊÚ·ÁÌfi ¤ÁÈÓÂ ÌÂ

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EÈÎ.1·: AÎÙÈÓÔÁÚ·ÊÈÎ‹ ÂÈÎfiÓ· ÙÔ˘¤ÁÎÏÂÈÛÙÔ˘ Î˘Ófi‰ÔÓÙ· ÌÂÙ¿ ÙËÓ·ÔÙ˘¯ËÌ¤ÓË ·fiÂÈÚ· ÔÚıÔ‰Ô-ÓÙÈÎ‹˜ ÙÔ˘ ÌÂÙ·Î›ÓËÛË˜ Î·È ÚÈÓÙË ÌÂÙÂÌÊ‡ÙÂ˘ÛË. EÈÎ. 1‚: AÎÙÈÓÔÁÚ·ÊÈÎ‹

ÂÈÎfiÓ· ÙÔ˘ Î˘Ófi‰ÔÓÙ·ÌÂÙ¿ ÙË ÌÂÙÂÌÊ‡ÙÂ˘-

ÛË. H ÂÓ‰Ô‰ÔÓÙÈÎ‹ ıÂ-Ú¿ÂÈ· ¤ÁÈÓÂ ÂÍˆÛÙÔ-

Ì·ÙÈÎ¿.

EÈÎ. 1Á: KÏÈÓÈÎ‹ ÂÈÎfiÓ· ÙÔ˘ ÌÂÙÂ-ÌÂÊ˘ÙÂ˘Ì¤ÓÔ˘ Î˘Ófi‰ÔÓÙ· 2 ¯Úfi-ÓÈ· ÌÂÙ¿ ÙË ÌÂÙÂÌÊ‡ÙÂ˘ÛË.

EÈÎ. 1‰: AÎÙÈÓÔÁÚ·ÊÈÎ‹ ÂÈÎfiÓ·ÙÔ˘ ÌÂÙÂÌÊ˘ÙÂ˘Ì¤ÓÔ˘ Î˘Ófi‰ÔÓÙ·

2 ¯ÚfiÓÈ· ÌÂÙ¿ ÙË ÌÂÙÂÌÊ‡ÙÂÛË.¶·Ú·ÙËÚÂ›Ù·È ÂÎÙÂÙ·Ì¤ÓË ·ÓÙÈÎ·-Ù·ÛÙ·ÙÈÎ‹ ·ÔÚÚfiÊËÛË ÙˆÓ Ô‰Ô-ÓÙÈÎÒÓ ÈÛÙÒÓ. O ÎÒÓÔ˜ ÁÔ˘Ù·¤Ú-

Î·˜ ·Ú·Ì¤ÓÂÈ ¿ıÈÎÙÔ˜.

EÈÎ. 2·: TÌ‹Ì· ·ÓÔÚ·-ÌÈÎ‹˜ ·ÎÙÈÓÔÁÚ·Ê›·˜ fi-Ô˘ ‰È·ÎÚ›ÓÔÓÙ·È Ô ¤ÎÙÔ-Ô˜ ÚÒÙÔ˜ ÚÔÁfiÌ-ÊÈÔ˜ (#34) Î·È Ô ¤ÁÎÏÂÈ-ÛÙÔ˜ Î˘Ófi‰ÔÓÙ·˜ (#33).

EÈÎ. 2‚: KÏÈÓÈÎ‹ ÂÈÎfiÓ·ÌÂÙ¿ ÙËÓ ÂÍ·ÁˆÁ‹ ÙÔ˘ ¤-ÁÎÏÂÈÛÙÔ˘ ÚÔÁfiÌÊÈÔ˘Î·È ÙËÓ Ù·˘Ùfi¯ÚÔÓË ÌÂ-ÙÂÌÊ‡ÙÂ˘ÛË ÙÔ˘ Î˘Ófi-‰ÔÓÙ·.

EÈÎ. 2Á: AÎÙÈÓÔ-ÁÚ·ÊÈÎ‹ ÂÈÎfiÓ·ÙÔ˘ Î˘Ófi‰ÔÓÙ·ÌÂÙ¿ ÙË ÌÂÙÂÌÊ‡-ÙÂ˘Û‹ ÙÔ˘.

EÈÎ. 2‰: ™ÙÔÓ ÌÂ-ÙÂÌÊ˘ÙÂ˘Ì¤ÓÔ Î˘-Ófi‰ÔÓÙ· ¤ÁÈÓÂ ÂÓ-‰Ô‰ÔÓÙÈÎ‹ ıÂÚ·-Â›· ÌÂÙ¿ ·Ô 15

ËÌ¤ÚÂ˜.

EÈÎ. 2Â: H ı¤ÛË ÙÔ˘ ‰ÔÓÙÈÔ‡ ‰ÂÓ Â-¤ÙÚÂ„Â ÙËÓ Û˘ÁÎÏÂÈÛÈ·Î‹ ÚÔ-ÛÙ·Û›· ÙÔ˘ (Û˘ÁÎÏÂÈÛÈ·Îfi Û¯‹Ì·Î˘ÓÔ‰ÔÓÙÈÎ‹˜ Î·ıÔ‰‹ÁËÛË˜).

EÈÎ. 2˙: AÎÙÈÓÔÁÚ·ÊÈÎ‹ ÂÈÎfiÓ· 2¯ÚfiÓÈ· ÌÂÙ¿ ÙË ÌÂÙÂÌÊ‡ÙÂ˘ÛË. ¶·-Ú·ÙËÚÂ›Ù·È ÌÈÎÚ‹ ÌfiÓÔ ·ÔÚÚfiÊËÛË ÛÙÔ ·ÎÚÔÚÚ›˙ÈÔ ÙÔ˘ ‰Ô-

ÓÙÈÔ‡ ·Ú¿ ÙËÓ ·˘ÍËÌ¤ÓË ÂÈ‚¿Ú˘ÓÛË ÙÔ˘ ‰ÔÓÙÈÔ‡ ·˘Ùfi ÙÔ‰È¿ÛÙËÌ· ÂÍ·ÈÙ›·˜ ÙË˜ Î˘ÓÔ‰ÔÓÙÈÎ‹˜ Î·ıÔ‰‹ÁËÛË˜.

ÚËÙ›ÓË Î·È ›ÓÂ˜ ̆ ·ÏÔÓËÌ¿ÙˆÓ (ÂÈÎ. 3‰). H ÎÏÈÓÈÎ‹ Î·È ·ÎÙÈ-ÓÔÏÔÁÈÎ‹ ÂÈÎfiÓ· ‰‡Ô ¯ÚfiÓÈ· ÌÂÙ¿ ˘‹ÚÍÂ ÈÎ·ÓÔÔÈËÙÈÎ‹(ÂÈÎ. 3Â).

¶ÂÚ›ÙˆÛË 4ËNÂ·Ú‹ ·ÛıÂÓ‹˜ 16 ÂÙÒÓ ˘Ô‚Ï‹ıËÎÂ ÛÂ ÂÍ·ÁˆÁ‹ ÙÔ˘#14 Î·È ‰ËÌÈÔ˘ÚÁ›· ¯ÒÚÔ˘ ÁÈ· ÙËÓ ÔÚıÔ‰ÔÓÙÈÎ‹ ÌÂÙ·Î›-ÓËÛË ÙÔ˘ ÂÁÎÏÂ›ÛÙÔ˘ #13, Ô˘, ˆÛÙfiÛÔ, ·Ô‰Â›¯ıËÎÂÌÂÚÈÎÒ˜ ·ÁÎ˘ÏˆÌ¤ÓÔ Î·È ‰ÂÓ ·ÓÙ·ÔÎÚ›ıËÎÂ Î·ıfiÏÔ˘ÛÙËÓ ÔÚıÔ‰ÔÓÙÈÎ‹ ıÂÚ·Â›· (ÂÈÎ. 4·). TÔ ‰fiÓÙÈ ÌÂÙÂÌÊ˘-ÙÂ‡ıËÎÂ ÛÙË ı¤ÛË ÙÔ˘ ÛÙÔ ÊÚ·ÁÌfi, ÛÙËÓ ÔÔ›· ¯ÚËÛÈ-ÌÔÔÈ‹ıËÎÂ ·Ú¯ÈÎ¿ ÙÔ ÔÚıÔ‰ÔÓÙÈÎfi Û‡ÚÌ· ÁÈ· ÙËÓ ·ÎÈ-ÓËÙÔÔ›ËÛ‹ ÙÔ˘, ‰Â‰ÔÌ¤ÓÔ˘ fiÙÈ ‰ÂÓ ̆ ‹Ú¯Â ÁÈ’ ·˘Ùfi ¿ˆÛËÌÂ›Ô Â·Ê‹˜ (ÂÈÎ. 4‚, 4Á). AÎÔÏÔ‡ıËÛÂ ÂÓ‰Ô‰ÔÓÙÈÎ‹ıÂÚ·Â›· ÌÂÙ¿ ·fi 15 ËÌ¤ÚÂ˜, ·ÙÂÏ‹˜ Û‡ÌÊˆÓ· ÌÂ ÙËÓÙÂÏÈÎ‹ ·ÎÙÈÓÔÁÚ·Ê›· Ë ÔÔ›· ·Ó·‰ÂÈÎÓ‡ÂÈ Â›ÛË˜ ÛËÌ·-ÓÙÈÎfi ÔÛÙÈÎfi ¤ÏÏÂÈÌÌ· Á‡Úˆ ·fi ÙË Ú›˙· ÙÔ˘ ‰ÔÓÙÈÔ‡

(ÂÈÎ. 4‰). 20 Ì‹ÓÂ˜ ·ÚÁfiÙÂÚ·, Î·È ÂÓÒ ÙÔ ‰fiÓÙÈ ·Ú·Ì¤ÓÂÈÛÙÔ ÊÚ·ÁÌfi, ·ÔÊ·Û›˙ÂÙ·È Ë ·ÓÙÈÎ·Ù¿ÛÙ·ÛË ÙÔ˘ ÂÏÏÂ›-ÔÓÙÔ˜ #14 ÌÂ ÂÌÊ‡ÙÂ˘Ì·, Î·Ù¿ ÙËÓ ÙÔÔı¤ÙËÛË ÙÔ˘ Ô-Ô›Ô˘ ‰È·ÈÛÙÒÓÂÙ·È ‰ÈÂÁ¯ÂÈÚËÙÈÎ¿ ÈÎ·ÓÔÔÈËÙÈÎ‹ ÔÛÙÈÎ‹

60


EÈÎ. 3·: TÌ‹Ì· ·ÓÔÚ·-ÌÈÎ‹˜ ·ÎÙÈÓÔÁÚ·Ê›·˜fiÔ˘ ‰È·ÎÚ›ÓÂÙ·È Ô ˘ÂÎÊ˘Ì¤ÓÔ˜ 2Ô˜ÁÔÌÊ›Ô˜ (#37).

EÈÎ. 3Â: AÎÙÈÓÔÁÚ·ÊÈÎ‹ÂÈÎfiÓ· ÙÔ˘ ‰ÔÓÙÈÔ‡ 2¯ÚfiÓÈ· ÌÂÙ¿ ÙË ÌÂÙÂÌÊ‡ÙÂ˘ÛË.

EÈÎ. 3Á: ŒÁÈÓÂ ÂÓ‰Ô‰ÔÓÙÈ-Î‹ ıÂÚ·Â›· Î·È ·ÎÚÔÚ-ÚÈ˙ÂÎÙÔÌ‹ ÂÍˆÛÙÔÌ·ÙÈÎ¿ÂÓÒ ÔÈ Ú›˙Â˜ ÙÔ˘ ‰ÔÓÙÈÔ‡‚Ú›ÛÎÔÓÙ·Ó Û˘ÓÂ¯Ò˜ ÛÂ˘ÁÚfi Î·È ÈÛfiÙÔÓÔ ÂÚÈ-‚¿ÏÏÔÓ Ù˘ÏÈÁÌ¤ÓÂ˜ ÌÂ ·ÔÛÙÂÈÚˆÌ¤ÓË Á¿˙·.

EÈÎ. 3‚: O 2Ô˜ ÁÔÌÊ›Ô˜ÌÂÙ¿ ÙËÓ ÂÍ·ÁˆÁ‹ ÙÔ˘.ŒÁÈÓÂ ÚÔÛ¿ıÂÈ· Ó·

ÚÔÛÙ·ÙÂ˘ıÂ› Ô ÂÚÈÔ-‰ÔÓÙÈÎfi˜ Û‡Ó‰ÂÛÌÔ˜

Î·Ù¿ ÙËÓ ÂÍ·ÁˆÁ‹ ÙÔ˘‰ÔÓÙÈÔ‡.

EÈÎ. 3‰: H ·ÎÈÓËÙÔÔ›Ë-ÛË ÙÔ˘ ‰ÔÓÙÈÔ‡ ÛÙË Ó¤·

ÙÔ˘ ı¤ÛË ÛÙÔ ÊÚ·ÁÌfi ¤ÁÈÓÂ ÌÂ ÚËÙ›ÓË Î·È ›ÓÂ˜

˘·ÏÔÓËÌ¿ÙˆÓ.

EÈÎ. 4·: KÏÈÓÈÎ‹ ÂÈÎfiÓ·ÙÔ˘ ¤ÁÎÏÂÈÛÙÔ˘ Î˘Ófi‰Ô-ÓÙ· ÌÂÙ¿ ÙËÓ ·ÓÂÈÙ˘¯‹ÚÛ¿ıÂÈ· ÔÚıÔ‰ÔÓÙÈÎ‹˜ÌÂÙ·Î›ÓËÛË˜. ¢È·ÎÚ›ÓÂÙ·ÈÙÔ ÔÚıÔ‰ÔÓÙÈÎfi ·ÁÎ‡ÏÈÔÔ˘ ¤¯ÂÈ ÎÔÏÏËıÂ› ÛÙÔ ¤ÁÎÏÂÈÛÙÔ ‰fiÓÙÈ.

EÈÎ. 4Â: KÏÈÓÈÎ‹ ÂÈÎfiÓ·20 Ì‹ÓÂ˜ ÌÂÙ¿ ÙË ÌÂÙÂÌ-Ê‡ÙÂ˘ÛË ÔfiÙÂ Ô ÂÏÏÂ›-ˆÓ #14 ·ÓÙÈÎ·ı›ÛÙ·Ù·ÈÌÂ ÂÌÊ‡ÙÂ˘Ì·. ¢È·È-ÛÙÒÓÂÙ·È ‰ÈÂÁ¯ÂÈÚËÙÈÎ¿ÛËÌ·ÓÙÈÎ‹ ÔÛÙÈÎ‹ ·Ó¿Ï·ÛË Á‡Úˆ ·Ô ÙÔÌÂÙÂÌÊ˘ÙÂ˘ı¤Ó ‰fiÓÙÈ.

EÈÎ. 4Ë: AÎÙÈÓÔÁÚ·ÊÈÎ‹ ÂÈÎfiÓ· 2 ¯ÚfiÓÈ· ÌÂ-Ù¿ ÙË ÌÂÙÂÌÊ‡ÙÂ˘ÛË. ¶·Ú·ÙËÚÂ›Ù·È ·ÔÚ-ÚfiÊËÛË ÙÔ˘ ÙÌ‹Ì·ÙÔ˜ ÙË˜ Ú›˙·˜ ÙÔ ÔÔ›Ô‰ÂÓ Â›¯Â ÂÌÊÚ·¯ıÂ› Î·Ù¿ ÙËÓ ÂÓ‰Ô‰ÔÓÙÈÎ‹ıÂÚ·Â›· Î·È ‰È¿Ï˘ÛË ÙÔ˘ Ê˘Ú¿Ì·ÙÔ˜Ca(OH)2 ÌÂÙ·Í‡ ÙˆÓ ÎÒÓˆÓ ÁÔ˘Ù·¤ÚÎ·˜.

EÈÎ. 4Á: KÏÈÓÈÎ‹ ÂÈÎfiÓ· 10ËÌ¤ÚÂ˜ ÌÂÙ¿ ÙË ÌÂÙÂÌÊ‡-ÙÂ˘ÛË.

EÈÎ. 4‚: KÏÈÓÈÎ‹ ÂÈÎfiÓ·ÙÔ˘ ‰ÔÓÙÈÔ‡ ÌÂÙ¿ ÙË

ÌÂÙÂÌÊ‡ÙÂ˘Û‹ ÙÔ˘ ÛÙÔÊÚ·ÁÌfi. TÔ ÔÚıÔ‰ÔÓÙÈÎfiÛ‡ÚÌ· ¯ÚËÛÈÌÔÔÈ‹ıËÎÂ

ÁÈ· ÙËÓ ·ÎÈÓËÙÔÔ›ËÛË.

EÈÎ. 4˙: KÏÈÓÈÎ‹ ÂÈÎfiÓ·ÌÂÙ¿ ·fi 2 ¯ÚfiÓÈ· ·fi

ÙË ÌÂÙÂÌÊ‡ÙÂ˘ÛË. TÔÂÌÊ‡ÙÂ˘Ì· ÛÙË ı¤ÛË

ÙÔ˘ ÂÏÏÂ›ÔÓÙ· #14 ¤¯ÂÈ·ÔÎ·Ù·ÛÙ·ıÂ›.

EÈÎ. 4‰: AÎÙÈÓÔÁÚ·ÊÈÎ‹ ÂÈÎfiÓ· ÙÔ˘ ‰ÔÓÙÈ-Ô‡ ÌÂÙ¿ ÙËÓ ÂÓ‰Ô‰ÔÓÙÈÎ‹ ıÂÚ·Â›· Ô˘

¤ÁÈÓÂ ÙË 15Ë ËÌ¤Ú· ÌÂÙ¿ ÙÔ ¯ÂÈÚÔ˘ÚÁÂ›Ô.H ÂÓ‰Ô‰ÔÓÙÈÎ‹ ıÂÚ·Â›· Â›Ó·È ·ÙÂÏ‹˜

Î·È Â›ÛË˜ ‰È·ÈÛÙÒÓÂÙ·È ÛËÌ·ÓÙÈÎfi ÔÛÙÈÎfi ¤ÏÏÂÈÌ·.


·Ó¿Ï·ÛË Á‡Úˆ ·fi ÙË Ú›˙· ÙÔ˘ ÌÂÙÂÌÊ˘ÙÂ˘ı¤ÓÙÔ˜ #13(ÂÈÎ. 4Â). MÂÙ¿ 4 Ì‹ÓÂ˜ (‰‡Ô ¯ÚfiÓÈ· ÌÂÙ¿ ÙËÓ ÌÂÙÂÌÊ‡-ÙÂ˘ÛË) ÙÔ ÂÌÊ‡ÙÂ˘Ì· ·ÔÎ·ı›ÛÙ·Ù·È (ÂÈÎ. 4˙) Î·È Ï‡ÂÙ·ÈË ·ÎÈÓËÙÔÔ›ËÛË ÙÔ˘ #13 (ÂÈÎ. 4Ë). ¶·Ú·ÙËÚÂ›Ù·È ·ÔÚ-ÚfiÊËÛË ÙÔ˘ ÙÌ‹Ì·ÙÔ˜ ÙË˜ Ú›˙·˜ Ô˘ ‰ÂÓ Â›¯Â ÂÌÊÚ·¯ıÂ›Î·È ‰È¿Ï˘ÛË ÙÔ˘ Ê˘Ú¿Ì·ÙÔ˜ Ca(OH)2 Ô˘ ‚ÚÈÛÎfiÙ·Ó ÌÂ-Ù·Í‡ ÙˆÓ ÎÒÓˆÓ ÁÔ˘Ù·¤ÚÎ·˜.

™YZHTH™HH ÌÂÙÂÌÊ‡ÙÂ˘ÛË ‰ÔÓÙÈÒÓ ·ÔÙÂÏÂ› Ì›· ˘ÔÏÔÁ›ÛÈÌË ıÂ-Ú·Â˘ÙÈÎ‹ ÂÈÏÔÁ‹ Î·ıÒ˜ ¤¯ÂÈ ‰ÈÎ¤˜ ÙË˜ ÂÓ‰Â›ÍÂÈ˜ Î·ÈÏÂÔÓÂÎÙ‹Ì·Ù· ¤Ó·ÓÙÈ ¿ÏÏˆÓ Û¯Â‰›ˆÓ ıÂÚ·Â›·˜. AÎfi-ÌË, ÌÂ ÂÊ·ÚÌÔÁ‹ Î·Ù¿ÏÏËÏˆÓ ÚˆÙÔÎfiÏÏˆÓ Ù· ÔÛÔ-ÛÙ¿ ÂÈÙ˘¯›·˜ ÛÙÈ˜ ÂÚÈÛÛfiÙÂÚÂ˜ ¤ÚÂ˘ÓÂ˜ Î˘Ì·›ÓÔÓÙ·ÈÁ‡Úˆ ÛÙÔ 75% ÌÂ 90% ÌÂ ‰fiÓÙÈ· Ó· ·Ú·Ì¤ÓÔ˘Ó ÛÙÔÊÚ·ÁÌfi ÁÈ· ·ÚÎÂÙ¿ ¯ÚfiÓÈ·6-9. Afi ÙË ÌÂÏ¤ÙË ÙˆÓ ÂÚÈ-ÙÒÛÂˆÓ Ô˘ ·ÚÔ˘ÛÈ¿˙ÔÓÙ·È Â‰Ò, Î·ıÒ˜ Î·È ·fi ÙËÓ·Ó·ÛÎfiËÛË ÙË˜ ‚È‚ÏÈÔÁÚ·Ê›·˜ Ô˘ ·ÎÔÏÔ˘ıÂ›, ı· ÌÔ-ÚÔ‡ÛÂ Ó· ıÂˆÚËıÂ› ˆ˜ ÂÈÙ˘¯›· Ë ·Ú·ÌÔÓ‹ ÙÔ˘ ‰ÔÓÙÈ-Ô‡ ÛÙÔ ÊÚ·ÁÌfi ÁÈ· ÂÚÈÛÛfiÙÂÚ· ·fi ÙÚ›· ¯ÚfiÓÈ· Î·È Ë·Ú·ÎÔÏÔ‡ıËÛË ÙÔ˘ ÌÈÎÚÔ‡ ‰Â›ÁÌ·ÙÔ˜ ÙË˜ ÌÂÏ¤ÙË˜ Ì·˜Û˘ÌÊˆÓÂ› ÌÂ Ù· ·Ú·¿Óˆ ÔÛÔÛÙ¿ ÂÈÙ˘¯›·˜.H ·ÙÚ·˘Ì·ÙÈÎ‹ ÂÍ·ÁˆÁ‹ Î·È Ë ÂÈ‚›ˆÛË Î˘ÙÙ¿ÚˆÓ ÙÔ˘ÂÚÈÚÚÈ˙›Ô˘ Ê·›ÓÂÙ·È fiÙÈ ¤·ÈÍÂ Î·ıÔÚÈÛÙÈÎfi ÚfiÏÔ ÛÙËÓÂÈ‚›ˆÛË ÙÔ˘ #37 ÙË˜ 3Ë˜ ÂÚ›ÙˆÛË˜, ÂÓÒ ÛÙË 2Ë Â-Ú›ÙˆÛË Ô ·Ú¿ÁÔÓÙ·˜ Ô˘ Èı·Ó¿ Û˘Ó¤‚·ÏÂ ÛÙËÓ ÂÈ-‚›ˆÛË ÙÔ˘ #33 ‹Ù·Ó Ë Î·ı˘ÛÙÂÚËÌ¤ÓË ÂÓ‰Ô‰ÔÓÙÈÎ‹ ıÂ-Ú·Â›· (ÌÂÙ¿ 15Óı‹ÌÂÚÔ) Ô˘ ÂÊ·ÚÌfiÛÙËÎÂ Â›ÛË˜ Î·ÈÛÙËÓ 4Ë ÂÚ›ÙˆÛË. H ÚfiˆÚË ·ÔÚÚfiÊËÛË ÛÙË Ú›˙·ÙÔ˘ #13 ÙË˜ 1Ë˜ ÂÚ›ÙˆÛË˜ ›Ûˆ˜ Ó· ÔÊÂ›ÏÂÙ·È ÛÙÔ fiÙÈÎ·Ì›· ·fi ÙÈ˜ ·Ú·¿Óˆ ÚÔ¸Ôı¤ÛÂÈ˜ ‰ÂÓ ÙËÚ‹ıËÎÂÛÙËÓ ÂÚ›ÙˆÛË ·˘Ù‹.™ÙË Û˘Ó¤¯ÂÈ· ·Ú·Ù›ıÂÓÙ·È ÔÈ ·fi„ÂÈ˜ Ô˘ ÂÈÎÚ·ÙÔ‡ÓÛ‹ÌÂÚ·, ÁÈ· Î¿ıÂ ÛÙ¿‰ÈÔ ÙË˜ ÌÂÙÂÌÊ‡ÙÂ˘ÛË˜ ¯ˆÚÈÛÙ¿,¤ÙÛÈ fiˆ˜ ÚÔÎ‡ÙÔ˘Ó ·fi ÙË ÌÂÏ¤ÙË ÙË˜ Û¯ÂÙÈÎ‹˜ ‚È-‚ÏÈÔÁÚ·Ê›·˜.

EÓ‰Ô‰ÔÓÙÈÎ‹ ıÂÚ·Â›· Î·È ÌÂÙÂÌÊ‡ÙÂ˘ÛËH Û˘¯ÓfiÙËÙ· Â·Ó·ÁÁÂ›ˆÛË˜ ÙÔ˘ ÔÏÊÔ‡ ÂÓfi˜ ÌÂÙÂÌ-Ê˘ÙÂ˘Ì¤ÓÔ˘ ‰ÔÓÙÈÔ‡ ÔÈÎ›ÏÏÂÈ ÛÂ ÌÂÁ¿ÏÔ ‚·ıÌfi, Î·ıÒ˜ÂÍ·ÚÙ¿Ù·È ¿ÌÂÛ· ·fi ÙÔ ̄ ÚfiÓÔ ÂÍˆÛÙÔÌ·ÙÈÎ‹˜ ·Ú·ÌÔ-Ó‹˜, ·fi ÙÔ Ì¤ÛÔ ÛÙÔ ÔÔ›Ô ‰È·ÙËÚ‹ıËÎÂ ÙÔ ‰fiÓÙÈ ÁÈ· fi-ÛÔ ̄ ÚfiÓÔ ‚ÚÈÛÎfiÙ·Ó ÂÎÙfi˜ Ê·ÙÓ›Ô˘ ·ÏÏ¿ Î·È ·fi ÙÔ ‚·ı-Ìfi ˆÚÈÌfiÙËÙ·˜ ÙÔ˘ ‰ÔÓÙÈÔ‡. ™ÙË ÌÂÙÂÌÊ‡ÙÂ˘ÛË, fiÔ˘ ËÙÔÔı¤ÙËÛË ÙÔ˘ ‰ÔÓÙÈÔ‡ Á›ÓÂÙ·È ¿ÌÂÛ·, ÛËÌ·ÓÙÈÎfiÙÂÚÔÚfiÏÔ Ê·›ÓÂÙ·È Ó· ·›˙ÂÈ Ô ‚·ıÌfi˜ ‰È¿Ï·ÛË˜ ÙÔ˘ ‰ÔÓÙÈ-Ô‡. T· ·ÓÒÚÈÌ· ‰fiÓÙÈ· ÌÂ ·ÓÔÈ¯Ùfi ·ÎÚÔÚÚ›˙ÈÔ Ê·›ÓÂÙ·ÈÓ· ¤¯Ô˘Ó ÛËÌ·ÓÙÈÎ¿ ÌÂÁ·Ï‡ÙÂÚË Èı·ÓfiÙËÙ· ÁÈ· Â·-Ó·ÁÁÂ›ˆÛË ÙÔ˘ ÔÏÊÔ‡ ÛÂ Û¯¤ÛË ÌÂ Ù· Ï‹Úˆ˜ ‰È·Ï·-ÛÌ¤Ó·10,11. EÓ‰Ô‰ÔÓÙÈÎ‹ ıÂÚ·Â›· (E£) ÚÔÙÂ›ÓÂÙ·È ÛÂÎ¿ıÂ ÂÚ›ÙˆÛË fiÔ˘ ÙÔ ‰fiÓÙÈ Â›Ó·È Ï‹Úˆ˜ ‰È·Ï·ÛÌ¤-ÓÔ ‹ Ë ÌÂÙÂÌÊ‡ÙÂ˘ÛË ¤¯ÂÈ Î·ı˘ÛÙÂÚ‹ÛÂÈ, ÂÓÒ fiÙ·Ó ÙÔ‰fiÓÙÈ Â›Ó·È ·ÓÒÚÈÌÔ (‰È¿Ï·ÛË ÙË˜ Ú›˙·˜ ¤ˆ˜ Ù· 3/4 Î·È·ÓÔÈ¯Ùfi ·ÎÚÔÚÚ›˙ÈÔ) ÚÔÙÂ›ÓÂÙ·È Ó· ÂÏ¤Á¯ÂÙ·È Ë ˙ˆÙÈÎfi-ÙËÙ· ÙÔ˘ ÔÏÊÔ‡ ÁÈ· 2 Â‚‰ÔÌ¿‰Â˜ Î·È ÛÙË Û˘Ó¤¯ÂÈ· Ó·Á›ÓÂÙ·È ÂÓ‰Ô‰ÔÓÙÈÎ‹ ıÂÚ·Â›· Â¿Ó ‰ÂÓ ·Ú·ÙËÚËıÔ‡ÓÛËÌÂ›· ˙ˆÙÈÎfiÙËÙ·˜12,13.¶ÈÛÙÂ‡ÂÙ·È fiÙÈ ÌÂÙ·Í‡ ÙË˜ 10Ë˜ Î·È 14Ë˜ ËÌ¤Ú·˜ ÌÂÙ¿ÙËÓ ÌÂÙÂÌÊ‡ÙÂ˘ÛË Â›Ó·È Ô Î·Ù·ÏÏËÏfiÙÂÚÔ˜ ¯ÚfiÓÔ˜ ÁÈ·

E£. EÓ‰Ô‰ÔÓÙÈÎ‹ ıÂÚ·Â›· Ô˘ Î·ı˘ÛÙÂÚÂ› ÌÂÙ¿ ÙËÓ14Ë ËÌ¤Ú· ¤¯ÂÈ Û˘Û¯ÂÙÈÛÙÂ› ÌÂ ·˘ÍËÌ¤Ó· ÔÛÔÛÙ¿ ÂÌ-Ê¿ÓÈÛË˜ ÊÏÂÁÌÔÓÒ‰Ô˘˜ ·ÔÚÚfiÊËÛË˜, ÂÓÒ Ë E£ ÚÈÓÙËÓ 10Ë ËÌ¤Ú· ‰ÂÓ Ê·›ÓÂÙ·È Ó· ÚÔÛÊ¤ÚÂÈ ÌÂÁ·Ï‡ÙÂÚ·ÔÛÔÛÙ¿ ÂÈÙ˘¯›·˜12. ™Â ÂÚÈÙÒÛÂÈ˜ fiÔ˘ ÙÔ ‰fiÓÙÈ Ú¤ÂÈ Ó· ‰È·ÙËÚËıÂ› ÁÈ·ÌÂÁ¿ÏÔ ‰È¿ÛÙËÌ· ÂÎÙfi˜ ÛÙfiÌ·ÙÔ˜, ÒÛÙÂ ¯ Ó· ‰ËÌÈÔ˘Ú-ÁËıÂ› ·ÚÎÂÙfi˜ ̄ ÒÚÔ˜ ÁÈ· ÙËÓ Â·Ó·ÙÔÔı¤ÙËÛ‹ ÙÔ˘ ÌÂÙ¿·fi ÔÚıÔ‰ÔÓÙÈÎ‹ ıÂÚ·Â›·, ˘¿Ú¯ÂÈ Ë ‰˘Ó·ÙfiÙËÙ· ÙË˜ÎÚ˘Ô‰È·Ù‹ÚËÛË˜ (cryopreservation), fiÔ˘ Ù· ‰fiÓÙÈ· ‰È·-ÙËÚÔ‡ÓÙ·È ÛÂ ÂÈ‰ÈÎfi ÂÚÈ‚¿ÏÏÔÓ ÛÂ ıÂÚÌÔÎÚ·Û›· -193Æ CÁÈ· ‰È¿ÛÙËÌ· ·ÚÎÂÙÒÓ ÌËÓÒÓ, ÒÛÙÂ ÛÙË Û˘Ó¤¯ÂÈ· Ó· Í·-Ó·¯ÚËÛÈÌÔÔÈËıÔ‡Ó14.H ·ÎÚÔÚÚÈ˙ÂÎÙÔÌ‹ Ê·›ÓÂÙ·È Ó· ÌËÓ ·˘Í¿ÓÂÈ ÙÔ ÔÛÔÛÙfiÂÈÙ˘¯›·˜ ÙË˜ ÌÂÙÂÌÊ‡ÙÂ˘ÛË˜ ÛÙÔÓ ¿ÓıÚˆÔ, ·Ú¿ ÙÔfiÙÈ ÛÂ ÂÈÚ¿Ì·Ù· ÛÂ ÛÎ‡ÏÔ˘˜ Ê¿ÓËÎÂ Ó· ‚ÂÏÙÈÒÓÂÈ Ù· ·-ÔÙÂÏ¤ÛÌ·Ù· ÙË˜ ‰È·‰ÈÎ·Û›·˜15.™˘ÌÂÚ·ÛÌ·ÙÈÎ¿, ÛÙ· Ï‹Úˆ˜ ‰È·Ï·ÛÌ¤Ó· ‰fiÓÙÈ· Ë ÂÓ-‰Ô‰ÔÓÙÈÎ‹ ıÂÚ·Â›· ·ÔÙÂÏÂ› Û˘Ó‹ıË ‰È·‰ÈÎ·Û›·. AÓÙ›-ıÂÙ·, ÛÙ· ‰fiÓÙÈ· ÌÂ ·ÓÔÈ¯Ùfi ·ÎÚÔÚÚ›˙ÈÔ (1>mm) Ë ÂÓ‰Ô-‰ÔÓÙÈÎ‹ ıÂÚ·Â›· ÌÔÚÂ› Ó· Î·ı˘ÛÙÂÚ‹ÛÂÈ. H Î·ı˘ÛÙ¤-ÚËÛË ·˘Ù‹ Á›ÓÂÙ·È ‰ÈfiÙÈ Â¿Ó Ù· ·ÓÒÚÈÌ· ‰fiÓÙÈ· ‰È·ÙËÚË-ıÔ‡Ó ˙ˆÓÙ·Ó¿, ¤¯Ô˘Ó ÙË ‰˘Ó·ÙfiÙËÙ· Ó· ‰È·Ï·ÛıÔ‡ÓÏ‹Úˆ˜12,16.TÔ ˘‰ÚÔÍÂ›‰ÈÔ ÙÔ˘ ·Û‚ÂÛÙ›Ô˘ ÚÔÙÂ›ÓÂÙ·È ˆ˜ ÙÔ Ï¤ÔÓÎ·Ù¿ÏÏËÏÔ Ê‡Ú·Ì· ¤ÌÊÚ·ÍË˜ ÂÍ·ÈÙ›·˜ ÙˆÓ ·ÓÙÈ‚·ÎÙË-ÚÈ·ÎÒÓ È‰ÈÔÙ‹ÙˆÓ ÙÔ˘, ÙË˜ ÈÎ·ÓfiÙËÙ¿˜ ÙÔ˘ Ó· ‰È·Ï‡ÂÈ ÙÔÓÓÂÎÚˆÙÈÎfi ÈÛÙfi, ·ÏÏ¿ Î·È ÂÂÈ‰‹ ˘¿Ú¯Ô˘Ó ÂÓ‰Â›ÍÂÈ˜ˆ˜ ÂÌÔ‰›˙ÂÈ ÙËÓ ÂÎ‰‹ÏˆÛË ÊÏÂÁÌÔÓÒ‰Ô˘˜ ·ÔÚÚfi-ÊËÛË˜12. ¶ÚÔÙÂ›ÓÂÙ·È Ë ·Ú·ÌÔÓ‹ ÙÔ˘ ˘‰ÚÔÍÂÈ‰›Ô˘ÛÙÔ˘˜ ÚÈ˙ÈÎÔ‡˜ ÛˆÏ‹ÓÂ˜ ÁÈ· 6-12 Ì‹ÓÂ˜ ‹ ¤ˆ˜ fiÙÔ˘ Â›Ó·ÈÔÚ·Ù‹ ·ÎÙÈÓÔÏÔÁÈÎ¿ ÔÏfiÎÏËÚË Ë lamina dura ÚÈÓ Á›ÓÂÈ¤ÌÊÚ·ÍË ÌÂ ÁÔ˘Ù·¤ÚÎ·. TÂÏÂ˘Ù·›Â˜ ÌÂÏ¤ÙÂ˜ ÚÔÙÂ›-ÓÔ˘Ó ÙËÓ ÙÔÔı¤ÙËÛË ˘‰ÚÔÍÂÈ‰›Ô˘ Ì›· Â‚‰ÔÌ¿‰· ÌÂÙ¿ÙËÓ ÌÂÙÂÌÊ‡ÙÂ˘ÛË Î·ıÒ˜ Û˘Û¯ÂÙ›˙Ô˘Ó ÙËÓ ÚˆÈÌfiÙÂÚËÙÔÔı¤ÙËÛË ˘‰ÚÔÍÂÈ‰›Ô˘ ÌÂ ·˘ÍËÌ¤Ó· ÔÛÔÛÙ¿ ·ÁÎ‡-ÏˆÛË˜17.E›ÛË˜, ÙÔ ˘ÏÈÎfi MTA (mineral trioxide aggregate) ¤¯ÂÈ¯ÚËÛÈÌÔÔÈËıÂ› ÙÂÏÂ˘Ù·›· ÛÂ ÂÚÈÛÙ·ÙÈÎ¿ ÌÂÙÂÌÊ‡ÙÂ˘-ÛË˜ ‰ÔÓÙÈÒÓ ÌÂ ÂÓı·ÚÚ˘ÓÙÈÎ¿ ·ÔÙÂÏ¤ÛÌ·Ù· ÛÙËÓ ·Ó·-¯·›ÙÈÛË ÙË˜ Ô‰ÔÓÙÈÎ‹˜ ·ÔÚÚfiÊËÛË˜18-20. øÛÙfiÛÔ, ÔÈ ‰Ë-ÌÔÛÈÂ‡ÛÂÈ˜ ·˘Ù¤˜ ·ÊÔÚÔ‡Ó Î˘Ú›ˆ˜ ·Ó·ÊÔÚ¤˜ ÂÚÈÛÙ·-ÙÈÎÒÓ Î·È ÁÈ· ·˘Ùfi ÙÔ ÏfiÁÔ ··ÈÙÂ›Ù·È ÂÚ·ÈÙ¤Úˆ ¤ÚÂ˘Ó·ÁÈ· Ó· ÙÂÎÌËÚÈˆıÂ› Ë ¯ÚËÛÈÌfiÙËÙ· ÙÔ˘ ˘ÏÈÎÔ‡ ·˘ÙÔ‡ÛÙËÓ ÚfiÏË„Ë Î·È Î·Ù·ÛÙÔÏ‹ ÙË˜ Ô‰ÔÓÙÈÎ‹˜ ·ÔÚÚfiÊË-ÛË˜ ÌÂÙÂÌÊ˘ÙÂ˘Ì¤ÓˆÓ ‰ÔÓÙÈÒÓ.

¶ÚÔÂÙÔÈÌ·Û›· ÙË˜ ‰¤ÎÙÚÈ·˜ ı¤ÛË˜ŒÓ· ¿ÏÏÔ ÛÙ¿‰ÈÔ ÙË˜ ÌÂÙÂÌÊ‡ÙÂ˘ÛË˜ ·ÔÙÂÏÂ› Ë ÚÔÂ-ÙÔÈÌ·Û›· ÙÔ˘ Ê·ÙÓ›Ô˘ Ô˘ ı· ‰Â¯ıÂ› ÙÔ ‰fiÓÙÈ. TÔ Ê·ÙÓ›Ô·˘Ùfi ÌÔÚÂ› Ó· ˘¿Ú¯ÂÈ fiÙ·Ó ¤¯ÂÈ ÚÔËÁËıÂ› ÂÍ·ÁˆÁ‹ÙÔ˘ ‰ÔÓÙÈÔ‡ Ô˘ ÚfiÎÂÈÙ·È Ó· ·ÓÙÈÎ·Ù·ÛÙ·ıÂ› ‹ Ó· Ú¤-ÂÈ Ó· ‰ËÌÈÔ˘ÚÁËıÂ› ÛÂ Óˆ‰‹ ı¤ÛË ÙË˜ Ê·ÙÓÈ·Î‹˜ ·ÎÚÔ-ÏÔÊ›·˜.™ÙËÓ ÚÒÙË ÂÚ›ÙˆÛË, fiÔ˘ ˘¿Ú¯ÂÈ Ê·ÙÓ›Ô, ·˘Ùfi Î·-ı·Ú›˙ÂÙ·È ·fi ·ÈÌ·ÙÈÎÔ‡˜ ıÚfiÌ‚Ô˘˜ Î·È ÔÛÙÈÎ¿ ıÚ·‡-ÛÌ·Ù· Ô˘ Èı·ÓfiÓ Ó· ¤¯Ô˘Ó ·ÔÌÂ›ÓÂÈ ÌÂÙ¿ ÙËÓ ÂÍ·Áˆ-Á‹ ÙÔ˘ ¿ÏÏÔ˘ ‰ÔÓÙÈÔ‡. H Î·Ï‹ Ï‡ÛË ÌÂ Ê˘ÛÈÔÏÔÁÈÎfi Ô-Úfi (ÙfiÛÔ ÙÔ˘ Ê·ÙÓ›Ô˘ fiÛÔ Î·È ÙÔ˘ ‰ÔÓÙÈÔ‡) ÎÚ›ÓÂÙ·È Ô-

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Ï‡ ÛËÌ·ÓÙÈÎ‹21,22.™ÙËÓ ÂÚ›ÙˆÛË Ô˘ Ú¤ÂÈ Ó· ‰È·ÌÔÚÊˆıÂ› ÂÍ·Ú¯‹˜Ê·ÙÓ›Ô ÛÙÔ ÔÛÙfi ÙË˜ ·ÎÚÔÏÔÊ›·˜ ÙfiÙÂ, ·Ó Î·È ˘¿Ú¯Ô˘Ó‰È¿ÊÔÚ· ÚˆÙfiÎÔÏÏ· Ô˘ ÌÔÚÂ› Ó· ·ÎÔÏÔ˘ıËıÔ‡Ó, ÔÈ‚·ÛÈÎ¤˜ ¯ÂÈÚÔ˘ÚÁÈÎ¤˜ ·Ú¯¤˜ Â›Ó·È ÔÈ ÂÍ‹˜23:°›ÓÂÙ·È ·ÓÙÈÛË„›· ÛÙË ‰¤ÎÙÚÈ· ı¤ÛË Î·È Û¯Â‰È¿˙ÂÙ·È ÙÚ·-Â˙ÔÂÈ‰‹˜ ÎÚËÌÓfi˜ Ô ÔÔ›Ô˜ Ó· ÚÔÛÊ¤ÚÂÈ Î·Ï‹ ÔÚ·Ùfi-ÙËÙ·. ™ÙË Û˘Ó¤¯ÂÈ· ÌÂ Î·Ù¿ÏÏËÏ· ÂÚÁ·ÏÂ›· (ÔÛÙÂÔÚ›ÓÂ˜,ÂÁÁÏ˘Ê›‰Â˜ ÔÛÙÔ‡ ÎÏ) ·Ú·ÛÎÂ˘¿˙ÂÙ·È ÙÔ Ê·ÙÓ›Ô ÙÔ Ô-Ô›Ô Ú¤ÂÈ fiÛÔ ÙÔ ‰˘Ó·ÙfiÓ Ó· ÚÔÛÔÌÔÈ¿˙ÂÈ ÙÔ Û¯‹Ì·ÙˆÓ ÚÈ˙ÒÓ ÙÔ˘ ‰ÔÓÙÈÔ‡ (ÁÈ’ ·˘Ùfi ÙÔ ÛÎÔfi ÌÔÚÔ‡Ó Ó·¯ÚËÛÈÌÔÔÈËıÔ‡Ó Î·È ÂÈ‰ÈÎ¿ ÔÌÔÈÒÌ·Ù· ‰ÔÓÙÈÒÓ ÛÂ Î·-Ù¿ÏÏËÏ· ÌÂÁ¤ıË) Î·È Ó· Â›Ó·È ÂÏ·ÊÚÒ˜ Â˘Ú‡ÙÂÚÔ. ™ÙËÛ˘Ó¤¯ÂÈ· Á›ÓÂÙ·È Ë ÂÍ·ÁˆÁ‹ ÙÔ˘ ‰ÔÓÙÈÔ‡ ÚÔ˜ ÌÂÙÂÌÂ-Ê‡ÙÂ˘ÛË (ÒÛÙÂ Ó· ÂÏ·¯ÈÛÙÔÔÈËıÂ› Ô ¯ÚfiÓÔ˜ ·Ú·ÌÔ-Ó‹˜ ÙÔ˘ ÂÎÙfi˜ ÛÙfiÌ·ÙÔ˜) ÌÂ ÚÔÛÔ¯‹ ÁÈ· Ó· ÌËÓ ÙÚ·˘-Ì·ÙÈÛıÂ› Ô ÂÚÈÔ‰ÔÓÙÈÎfi˜ Û‡Ó‰ÂÛÌÔ˜ Î·È ÙÔÔıÂÙÂ›Ù·È¯ˆÚ›˜ ›ÂÛË ÛÙË Ó¤· ÙÔ˘ ı¤ÛË. E›Ó·È ÛËÌ·ÓÙÈÎfi Ó· Á›ÓÔ-ÓÙ·È ÔÈ ̄ ÂÈÚÈÛÌÔ› ÙÔ˘ ‰ÔÓÙÈÔ‡ ·fi ÙË Ì‡ÏË ÙÔ˘ Î·È Ó· ÌËÓ¤ÚıÂÈ Î·ıfiÏÔ˘, Â¿Ó Â›Ó·È ‰˘Ó·Ùfi, Ë Ú›˙· ÛÂ Â·Ê‹ ÌÂ Ù·ÂÚÁ·ÏÂ›·. E¿Ó ˘¿Ú¯ÂÈ ‰˘ÛÎÔÏ›· ÛÙË ÙÔÔı¤ÙËÛË ÙÔ˘‰ÔÓÙÈÔ‡ ÙfiÙÂ ·˘Ùfi ÌÔÚÂ› Ó· ÙÔÔıÂÙËıÂ› Î·È ÌÂ ÛÙÚÔ-Ê‹. T¤ÏÔ˜, Â·Ó·Ê¤ÚÂÙ·È Ô ÎÚËÌÓfi˜ ÒÛÙÂ Ó· ÂÊ·ÚÌfi˙ÂÈÎ·Ï¿ Á‡Úˆ ·fi ÙÔÓ ·˘¯¤Ó· ÙÔ˘ ‰ÔÓÙÈÔ‡. H ÙÔÔı¤ÙËÛËÙÔ˘ ‰ÔÓÙÈÔ‡ Î·Ïfi Â›Ó·È Ó· Á›ÓÂÙ·È ÛÂ ·ÎÚÔÚÚÈ˙ÈÎfiÙÂÚËı¤ÛË ·fi Ù· ˘fiÏÔÈ·, ÒÛÙÂ Ó· ‚Ú›ÛÎÂÙ·È ÂÎÙfi˜ Û‡-ÁÎÏÂÈÛË˜ ·ÏÏ¿ Î·È Ó· ̆ ¿Ú¯ÂÈ ‰˘Ó·ÙfiÙËÙ· ÁÈ· ÙËÓ Ï‹ÚË‰È¿Ï·ÛË ÙË˜ Ú›˙·˜ Â¿Ó ÙÔ ‰fiÓÙÈ Â›Ó·È ·ÓÒÚÈÌÔ.H Â¿ÏÂÈ„Ë ÙÔ˘ Ê·ÙÓ›Ô˘ ÌÂ ·ÌÂÏÔÁÂÓ›ÓË (·Ú¿ÁˆÁÔ ·-‰·Ì·ÓÙÈÓÈÎ‹˜ Ì‹ÙÚ·˜ ¯Ô›ÚÔ˘) ÚÔÙÂ›ÓÂÙ·È ·fi ‰È¿ÊÔÚ·ÚˆÙfiÎÔÏÏ·24, Î·ıÒ˜ ÈÛÙÂ‡ÂÙ·È ˆ˜ ·˘Ùfi ÂÓÈÛ¯‡ÂÈ ÙËÓ‰È·‰ÈÎ·Û›· ÂÔ‡ÏˆÛË˜ ÙÔ˘ ÂÚÈÔ‰ÔÓÙÈÎÔ‡ Û˘Ó‰¤ÛÌÔ˘(¶™), ÂÌÔ‰›˙ÔÓÙ·˜ ¤ÙÛÈ ÙËÓ ·ÁÎ‡ÏˆÛË ÙÔ˘ ‰ÔÓÙÈÔ‡. OÈ¤ÚÂ˘ÓÂ˜, fiÌˆ˜, ÚÔ˜ ÙÔ ·ÚfiÓ, ·ÚÔ˘ÛÈ¿˙Ô˘Ó ·ÓÙÈ-ÎÚÔ˘fiÌÂÓ· ·ÔÙÂÏ¤ÛÌ·Ù·25-27 ÁÈ· ÙÔ ·Ó Ë ÂÊ·ÚÌÔÁ‹ ÙÔ˘‚ÂÏÙÈÒÓÂÈ ÛËÌ·ÓÙÈÎ¿ ÙËÓ ·Ó·Û‡ÛÙ·ÛË ÙÔ˘ ¶™.

AÎÈÓËÙÔÔ›ËÛË ÙÔ˘ ÌÂÙÂÌÊ˘ÙÂ˘Ì¤ÓÔ˘ ‰ÔÓÙÈÔ‡H ·ÎÈÓËÙÔÔ›ËÛË ÂÓfi˜ ÌÂÙÂÌÊ˘ÙÂ˘Ì¤ÓÔ˘ ‰ÔÓÙÈÔ‡ Û˘-ÛÙ‹ÓÂÙ·È ÒÛÙÂ Ó· ÂÈÙÚ¤„ÂÈ ÙËÓ ÂÚÈÔ‰ÔÓÙÈÎ‹ Î·È ÔÏÊÈ-Î‹ ÂÔ‡ÏˆÛË Î·ıÒ˜ Ë ÎÈÓËÙÈÎfiÙËÙ· Î·Ù¿ ÙËÓ ÂÔ‡ÏˆÛË·˘Í¿ÓÂÈ ÙÔÓ Î›Ó‰˘ÓÔ ÁÈ· ÂÚ·ÈÙ¤Úˆ ÙÚ·‡Ì· Î·È ÂÈÏÔ-Î¤˜. OÈ ·Ï·ÈfiÙÂÚÂ˜ Ô‰ËÁ›Â˜ ÚÔÙÂ›ÓÔ˘Ó ·ÎÈÓËÙÔÔ›ËÛËÁÈ· 4-6 Â‚‰ÔÌ¿‰Â˜28 ‹ Î·È ÂÚÈÛÛfiÙÂÚÔ, ÂÓÒ ÛÙÈ˜ ÙÂÏÂ˘-Ù·›Â˜ Û˘ÛÙ¿ÛÂÈ˜ Ë ·ÎÈÓËÙÔÔ›ËÛË ÂÚÈÔÚ›˙ÂÙ·È ÛÂ 1-2 Â-‚‰ÔÌ¿‰Â˜26. øÛÙfiÛÔ, ÔÏÏÔ› ̆ ÔÛÙËÚ›˙Ô˘Ó ˆ˜ Ë ÂÈÙ˘-¯‹˜ ÂÚÈÔ‰ÔÓÙÈÎ‹ ÂÔ‡ÏˆÛË ÌÂÙ¿ ÙËÓ ÌÂÙÂÌÊ‡ÙÂ˘ÛË‰ÂÓ ÂËÚÂ¿˙ÂÙ·È ·fi ÙÔ Â¿Ó ı· Á›ÓÂÈ ‹ fi¯È Ó·ÚıËÎÔÔ›Ë-ÛË Î·È ·fi ÙÈ˜ ÙÂ¯ÓÈÎ¤˜ ÙË˜ ÏÂÙÔÌ¤ÚÂÈÂ˜26. H ·Ú·ÙÂÙ·-Ì¤ÓË, Û˘Ì·Á‹˜ ·ÎÈÓËÙÔÔ›ËÛË Â›Ó·È Èı·Ófi Ó· Û˘Ó‰¤Â-Ù·È ÌÂ ·˘ÍËÌ¤Ó· ÔÛÔÛÙ¿ ·ÁÎ‡ÏˆÛË˜ Î·È ÔÏÊÈÎ‹˜ Ó¤-ÎÚˆÛË˜29,30. MÂÁ·Ï‡ÙÂÚË ÛËÌ·Û›· ÁÈ· ÙËÓ ÂÔ‡ÏˆÛËÊ·›ÓÂÙ·È Ó· ¤¯Ô˘Ó ·Ú¿ÁÔÓÙÂ˜ fiˆ˜ Ô ¯ÚfiÓÔ˜ ÂÍˆÛÙÔ-Ì·ÙÈÎ‹˜ ·Ú·ÌÔÓ‹˜ ÙÔ˘ ‰ÔÓÙÈÔ‡ Î·È ÙÔ Ì¤ÛÔ ‰È·Ù‹ÚË-Û‹˜ ÙÔ˘ ·Ú¿ Ë Ó·ÚıËÎÔÔ›ËÛ‹ ÙÔ˘23,24.TÂÏÈÎ¿ ÂÈÎÚ·Ù¤ÛÙÂÚË ›Ûˆ˜ Â›Ó·È ÌÈ· ÂÓ‰È¿ÌÂÛË ¿Ô„Ë,ÁÈ· Ó·ÚıËÎÔÔ›ËÛË ‰È¿ÚÎÂÈ·˜ 1-2 Â‚‰ÔÌ¿‰ˆÓ Ë ÔÔ›·Ú¤ÂÈ Ó· Â›Ó·È ËÌÈ-ÂÏ·ÛÙÈÎ‹ Î·ıÒ˜ Ë ÌÈÎÚ‹ ·˘Ù‹ ÎÈÓËÙÈ-ÎfiÙËÙ· Ê·›ÓÂÙ·È Ó· ·ÔÙÂÏÂ› ÛËÌ·ÓÙÈÎfi ÂÚ¤ıÈÛÌ· ÁÈ·

ÙËÓ Î·Ï‡ÙÂÚË ÂÚÈÔ‰ÔÓÙÈÎ‹ ÂÔ‡ÏˆÛË29,30. E¿Ó ‚¤‚·È· È-‰È·›ÙÂÚÂ˜ Û˘Óı‹ÎÂ˜, fiˆ˜ ÌÂÁ¿ÏÔ ¤ÏÏÂÈÌÌ· ÔÛÙÔ‡, ÂÈ-‚¿ÏÏÔ˘Ó ·ÎÈÓËÙÔÔ›ËÛË ÁÈ· ÌÂÁ·Ï‡ÙÂÚÔ ¯ÚÔÓÈÎfi ‰È¿-ÛÙËÌ· ÙfiÙÂ ·˘Ù‹ Ú¤ÂÈ Ó· ÂÂÎÙÂ›ÓÂÙ·È ¯ÚÔÓÈÎ¿29. HÓ·ÚıËÎÔÔ›ËÛË ÌÔÚÂ› Ó· Á›ÓÂÈ ÌÂ Û‡ÚÌ· ÔÚıÔ‰ÔÓÙÈ-Î‹˜, ÌÂ Û‡ÓıÂÙË ÚËÙ›ÓË ·ÎfiÌË Î·È ÌÂ Ú¿ÌÌ·Ù·4.

XÔÚ‹ÁËÛË ·ÓÙÈ‚ÈÔÙÈÎÒÓH ¯ÔÚ‹ÁËÛË ·ÓÙÈ‚›ˆÛË˜ Î·Ù¿ ÙÈ˜ ÂfiÌÂÓÂ˜ Ì¤ÚÂ˜ ÙË˜ÌÂÙÂÌÊ‡ÙÂ˘ÛË˜ ˘‹ÚÍÂ ¿ÁÈ· Ù·ÎÙÈÎ‹ Î·È ÚÔÙÂ›ÓÔÓÙ·ÈÁÈ’ ·˘Ùfi ‰È¿ÊÔÚ· ·ÓÙÈ‚ÈÔÙÈÎ¿ Û¯‹Ì·Ù· ÁÈ· ¿ÏÏÔÙÂ ¿ÏÏÔ¯ÚÔÓÈÎfi ‰È¿ÛÙËÌ· ÌÂ ÛÎÔfi ÙÔÓ ¤ÏÂÁ¯Ô ÙË˜ ÌfiÏ˘ÓÛË˜Î·È ÙÔÓ ÂÚÈÔÚÈÛÌfi ÙË˜ ÊÏÂÁÌÔÓÒ‰Ô˘˜ ·ÔÚÚfiÊËÛË˜.™Â ÔÚÈÛÌ¤ÓÂ˜ ÌÂÏ¤ÙÂ˜ ˆÛÙfiÛÔ ‰Â Ê·›ÓÂÙ·È ÛÙ·ÙÈÛÙÈÎ¿ÛËÌ·ÓÙÈÎ‹ Û˘Û¯¤ÙÈÛË ÌÂÙ·Í‡ ÙË˜ ¯ÔÚ‹ÁËÛË˜ ‹ ÌË ·ÓÙÈ-‚›ˆÛË˜ Î·È ÙË˜ ÂÚÈÔ‰ÔÓÙÈÎ‹˜ ÂÔ‡ÏˆÛË˜ ¯ˆÚ›˜ ·ÔÚ-ÚfiÊËÛË31. EÂÈ‰‹, fiÌˆ˜ Ù· Ó¤· ÛÙÔÈ¯Â›· ·˘Ù¿ ıÂˆÚÔ‡-ÓÙ·È ·ÎfiÌË ·ÓÂ·ÚÎ‹, Û˘ÛÙ‹ÓÂÙ·È Ó· ·ÎÔÏÔ˘ıÔ‡ÓÙ·È ÔÈÔ‰ËÁ›Â˜ ÁÈ· ¯ÔÚ‹ÁËÛË ·ÓÙÈ‚›ˆÛË˜ Â˘Ú¤o˜ Ê¿ÛÌ·ÙÔ˜ÁÈ· ÂÚ›Ô˘ Ì›· Â‚‰ÔÌ¿‰·, ·Ó¿ÏÔÁ· ÌÂ ÙÈ˜ È‰È·ÈÙÂÚfiÙË-ÙÂ˜ ÙÔ˘ ÂÚÈÛÙ·ÙÈÎÔ‡31.

O‰ËÁ›Â˜ Î·È Â·Ó¤ÏÂÁ¯ÔÈ ÙÔ˘ ‰ÔÓÙÈÔ‡MÂÙ¿ ÙËÓ ÌÂÙÂÌÊ‡ÙÂ˘ÛË ÙÔ˘ ‰ÔÓÙÈÔ‡ Ú¤ÂÈ Ó· ‰›ÓÔÓÙ·ÈÛ·ÊÂ›˜ Ô‰ËÁ›Â˜ ÛÙÔÓ ·ÛıÂÓ‹ ·ÏÏ¿ Î·È ÛÙÔ˘˜ ÁÔÓÂ›˜, Â¿Ó¤¯Ô˘ÌÂ Ó· Î¿ÓÔ˘ÌÂ ÌÂ ÓÂ·Ú¿ ¿ÙÔÌ·. TÔ ‰fiÓÙÈ ‰ÂÓ Ú¤ÂÈÓ· ÊÔÚÙ›˙ÂÙ·È Î·Ù¿ ÙË Ì¿ÛËÛË Î·È ÁÈ’ ·˘Ùfi Û˘ÛÙ‹ÓÔÓÙ·ÈÌ·Ï·Î¤˜ ÙÚÔÊ¤˜ ÁÈ· 2 Â‚‰ÔÌ¿‰Â˜24. ™˘ÛÙ‹ÓÂÙ·È Â›ÛË˜ÔÏ‡ ÚÔÛÂÎÙÈÎ‹ „‹ÎÙÚÈÛË ÌÂ Ì·Ï·Î‹ Ô‰ÔÓÙfi‚Ô˘ÚÙÛ·ÌÂÙ¿ ·fi Î¿ıÂ ÁÂ‡Ì· Î·È Ó· Á›ÓÂÙ·È ¯Ú‹ÛË ÛÙÔÌ·ÙÈÎÔ‡‰È·Ï‡Ì·ÙÔ˜ ¯ÏˆÚÂÍÈ‰›ÓË˜ (0,1%) 2 ÊÔÚ¤˜ ËÌÂÚËÛ›ˆ˜ Â-› 1 Â‚‰ÔÌ¿‰·21. OÈ Ù·ÎÙÈÎÔ› Â·Ó¤ÏÂÁ¯ÔÈ ÁÈ· ÙÔÓ Î·ıÔÚÈÛÌfi ÙË˜ ÔÚÂ›·˜ÙÔ˘ ‰ÔÓÙÈÔ‡ Î·È ÁÈ· ÙÈ˜ ÂÚ·ÈÙ¤Úˆ ıÂÚ·Â˘ÙÈÎ¤˜ ÂÓ¤Ú-ÁÂÈÂ˜ Â›Ó·È ÔÏ‡ ÛËÌ·ÓÙÈÎÔ›.

™YM¶EPA™MATAH ÌÂÙÂÌÊ‡ÙÂ˘ÛË ‰ÔÓÙÈÒÓ ÌÔÚÂ› Ó· ÚÔÛÊ¤ÚÂÈ ·ÍÈfiÏÔ-ÁÂ˜ ıÂÚ·Â˘ÙÈÎ¤˜ Ï‡ÛÂÈ˜ ÛÂ ÂÚÈÙÒÛÂÈ˜ ·ÛıÂÓÒÓ fiÔ˘¿ÏÏ· Û¯¤‰È· ıÂÚ·Â›·˜ ¤¯Ô˘Ó ÛËÌ·ÓÙÈÎ¿ ÌÂÈÔÓÂÎÙ‹Ì·Ù·Î·È ·ÓÙÂÓ‰Â›ÍÂÈ˜. °È’ ·˘Ùfi ÙÔ ÏfiÁÔ Ë ÁÓÒÛË ÙˆÓ ÂÓ‰Â›ÍÂ-ˆÓ, ÙˆÓ ‚ÈÔÏÔÁÈÎÒÓ ÌË¯·ÓÈÛÌÒÓ Î·È ÙˆÓ ÂÈÏÔÎÒÓ ÙË˜ÌÂÙÂÌÊ‡ÙÂ˘ÛË˜ ÌÔÚÂ› Ó· Â›Ó·È ¯Ú‹ÛÈÌÔ ÂÚÁ·ÏÂ›Ô ÁÈ·ÙÔÓ Ô‰ÔÓÙ›·ÙÚÔ. T¤ÏÔ˜, Ë Û˘ÓÂ¯‹˜ ÂÓËÌ¤ÚˆÛË ÁÈ· ÙÈ˜ÙÚÔÔÔÈ‹ÛÂÈ˜ ÙˆÓ ÚˆÙÔÎfiÏÏˆÓ Ô˘ ·ÊÔÚÔ‡Ó ÛÙËÓÂ˘·›ÛıËÙË Î·È ÔÏ‡ÏÔÎË ·˘Ù‹ ‰È·‰ÈÎ·Û›· Â›Ó·È ··Ú·›-ÙËÙË ÒÛÙÂ Ó· ÂÈÙÂ˘¯ıÂ› ÙÔ Î·Ï‡ÙÂÚÔ ıÂÚ·Â˘ÙÈÎfi ·Ô-Ù¤ÏÂÛÌ· Î·È Ó· ÌÂÈˆıÂ› Ë Èı·ÓfiÙËÙ· ÂÈÏÔÎÒÓ.

SUMMARY

Tooth transplantationVenetis G., Liokatis P.G., Katsikanis F.


Tooth transplantation refers to the extraction of a toothfrom one location and its replantation in a different

location. When donor and recipient sites belong to thesame person then it is called autogeneous toothtransplantation or tooth auto-transplantation. This is thetooth transplantation type that is going to be discussed inthis paper. It is a method with various success rateswhich can be a possible treatment plan with its ownindications and contra-indications, advantages anddisadvantages.This review presents the indications, perspectives,benefits and difficulties of tooth auto-transplantation.The factors that play a decisive role to the progress ofthe procedure are pointed. Furthermore, the mainbiologic mechanisms which are involved in auto-transplantation, those referring to trauma healing, arediscussed. Those mechanisms also trigger possiblecomplications which follow this method, mainlyreplacement resorption that is also explained in thisreview. In addition to these, a series of 4 auto-transplantation cases is presented. Finally, theguidelines according to modern bibliography aboutauto-transplantation are discussed. Following theseguidelines will result in better success rates. In conclusion, tooth auto-transplantation is ademanding surgical procedure. The dentist can reducethe possibility of complications and increase thesuccess rate by applying a methodology based on themodern guidelines about tooth auto-transplantation.This will ensure that the transplanted teeth will remain fora significant period of time functional, offering anotherpossible treatment plan with various advantages for hispatient oral health.

Key words: tooth auto-transplantation; replacementresorption; tooth auto-transplantation protocol

BIB§IO°PAºIA1. AÁÁÂÏfiÔ˘ÏÔ˜ A, AÏÂÍ·Ó‰Ú›‰Ë˜ K, K·ÙÛÈÎ¤ÚË˜ N: ™‡Á¯ÚÔ-

ÓË ÛÙÔÌ·ÙÈÎ‹ Î·È ÁÓ·ıÔÚÔÛˆÈÎ‹ ¯ÂÈÚÔ˘ÚÁÈÎ‹. 2Ë ŒÎ‰Ô-ÛË. AÁÁÂÏfiÔ˘ÏÔ˜ ÕÁÁÂÏÔ˜. Aı‹Ó·. 2007: 391.

2. Natiella JR, Armitage JE, Greene GW: The replantation andtransplantation of teeth. A review. Oral Surg Oral Med OralPathol 1970; 29(3):397-419.

3. Peter PP: Autogenous transplantation of maxillary andmandibular molars. J Oral Maxillofac Surg 2008; 66:2314-2317.

4. Thomas S, Turner SR, Sandy JR: Autotransplantation ofteeth. Is there a role? Br J Orthod 1998; 25(4):275-82.

5. Andreasen JO: Analysis of pathogenesis and topography ofreplacement resorption (ankylosis) after replacement ofmature permanent incisors in monkeys. Swed Dent J 1980;4:231-40.

6. Kim E, Jung JY et al: Evaluation of the prognosis and causesof failure in 182 cases of autogenous tooth transplantation.Oral Surg Oral Med Oral Pathol Oral Radiol Endod2005;100(1);112-9.

7. Gonnissen H, Politis C, Schepers S, Lambrichts I, VrielinckL, Sun Y et al: Long-term success and survival rates ofautogenously transplanted canines. Oral Surg Oral MedOral Pathol Oral Radiol Endod 2010; 110:570-578.

8. Kvint S, Lindsten R, Magnusson A, Nilsson P, Bjerklin K:Autotransplantation of teeth in 215 patients. A follow-upstudy. Angle Orthod 2010; 80(3):446-51.

9. Schwartz O, Bergmann P, Klausen B; Autotransplantation ofhuman teeth. A life-table analysis of prognostic factors. Int JOral Surg 1985; 14:245-258.

10. Andreasen JO, Andreasen FM, Skeie A, Hjorting-Hansen E,Schwartz O: Effect of treatment delay upon pulp andperiodontal healing of traumatic dental injuries- a reviewarticle. Dent Traumatol 2002; 18:116-128.

11. Pohl Y, Wahl G, Filippi A, Kirschner H: Results afterreplantation of avulsed permanent teeth. III. Tooth loss andsurvival analysis. Dent Traumatol 2005; 21:102-110.

12. Hinckfuss SE, Messer LB: An evidence-based assessmentof the clinical guidelines for replanted avulsed teeth. Part 1:timing of pulp extirpation. Dent Traumatol 2009; 25:32-42.

13. Flores MT, Andreasen JO, Bakland LK: Guidelines for theevaluation and management of traumatic dental injuries.Dent Traumatol 2001; 17:193-6.

14. Temmerman L, De Pauw GA, Beele H, Dermaut LR: Toothtransplantation and cryopreservation: state of the art. Am JOrthod Dentofacial Orthop 2006; 129(5):691-5.

15. Andreasen JO, Schwartz O, Andreasen FM: The effect ofapicoectomy before replantation on periodontal and pulpalhealing in teeth in monkeys. Int J Oral Surg 1985; 14:176-183.

16. Finucane D, Kinirons MJ: External inflammatory andreplacement resorption of luxated and avulsed replantedpermanent incisors: a review and case presentation. DentTraumatol 2003; 19:170-174.

17. Lengheden A, Blomlof L, Lindskog S: Effect of immediatecalcium hydroxide treatment and permanent root-filling onperiodontal healing in contaminated teeth. Scand J DentRes 1991; 99:139-46.

18. Guzeler I, Uysal S, Cehreli ZC: Management of trauma-induced inflammatory root resorption using mineral trioxideaggregate obturation: two year follow-up. Dent Traumatol.2010; 26(6):501-4.

19. Aqqarwal V, Sinqla M: Management of inflammatory rootresorption using MTA obturation - a four year follow up. BrDent J 2010 Apr 10; 208(7):287-9.

20. Jacobovitz M, de Pontes Lima RK: The use of calciumhydroxide and mineral trioxide aggregate on apexification ofa replanted tooth: a case report. Dent Traumatol. 2009;25(3):e32-6.

21. Panzarini SR, Gulinelli JL, Poi WR, Sonoda CK, Pedrini D,Brandini DA: Treatment of root surface in delayed toothreplantation: a review of literature. Dent Traumatol 2008;24:277-282.

22. Panzarini SR, Perri De Carvalho AC, Poi WR, Sonoda CK:Use of vitamin C in delayed tooth replantation. Braz Dent J2005; 16: 17-22.

23. Northway WM, Koningsberg S: Autogenic toothautotransplantation. The “state of the art”. Am J Orthod1980; 77(2);146-82.

24. Flores MT, Andreasen JO, Bakland LK et al: Guidelines forthe evaluation and management of traumatic dental injuries.Dent Traumatol 2001; 17:193-196.

25. Hamamoto Y, Kawasaki N, Jarnbring F, Hammarstrom L:Effects and distribution of the enamel matrix derivativeEmdogain in the periodontal tissues of rat molars



transplanted to the abdominal wall. Dent Traumatol 2002;18:12-23.

26. Filippi A, Pohl Y, von Arx T: Treatment of replacementresorption with Emdogain- preliminary results after 10months. Dent Traumatol 2001; 17:134-8.

27. Filippi A, Pohl Y, von Arx T: Treatment of replacementresorption with Emdogain-a prospective clinical study. DentTraumatol 2002; 18:138-43.

28. Andreasen JO, Borum MK, Jacobsen HL, Andreasen FM:Replantation of 400 avulsed permanent incisors. 1.Diagnosis of healing complications. Endod Dent Traumatol

1995; 11:51-8.29. Hinckfuss SE, Messer LB: Splinting duration and

periodontal outcomes for replanted avulsed teeth: asystematic review. Dent Traumatol 2009; 25:150-157.

30. Kahler B, Heithersay GS: An evidence-based appraisal ofsplinting luxated, avulsed and root-fractured teeth. DentTraumatol 2008; 24:2-10.

31. Hinckfuss SE, Messer LB: An evidence-based assessmentof the clinical guidelines for replanted avulsed teeth. Part II:prescription of systemic antibiotics. Dent Traumatol 2009;25:158-164.

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O ÛÎÔfi˜ ÙË˜ ÂÚÁ·Û›·˜ Â›Ó·È Ó· ·) ·ÚÔ˘ÛÈ¿ÛÂÈ Â˘Ú‹Ì·Ù· ÙË˜ ‚È‚ÏÈÔÁÚ·Ê›·˜ Û¯ÂÙÈÎ¿ ÌÂ ÙËÛÙÔÌ·ÙÈÎ‹ ˘ÁÂ›· Î·È ÙËÓ ·Ó¿ÁÎË ·ÚÔ¯‹˜ Ô‰ÔÓÙÈ·ÙÚÈÎ‹˜ ıÂÚ·Â›·˜ ÛÙ· ¿ÙÔÌ· ÌÂ ÂÈ‰ÈÎ¤˜ ·-Ó¿ÁÎÂ˜ (AMÂA), ‚) ÂÚÈÁÚ¿„ÂÈ Ù· ·ÔÙÂÏ¤ÛÌ·Ù· ÌÂÏ¤ÙË˜ Û¯ÂÙÈÎ¿ ÌÂ ÙË ÁÓÒÛË, ÛÙ¿ÛË Î·ÈÚ·ÎÙÈÎ¤˜ Ô‰ÔÓÙÈ¿ÙÚˆÓ Ô˘ ·Ú·ÎÔÏÔ‡ıËÛ·Ó ÙÔ 26Ô ¶·ÓÂÏÏ‹ÓÈÔ O‰ÔÓÙÈ·ÙÚÈÎfi ™˘Ó¤‰ÚÈÔ, ÁÈ·ÙË ÊÚÔÓÙ›‰· ·˘ÙÒÓ ÙˆÓ ·ÙfiÌˆÓ, Á) Ó· ·ÚÔ˘ÛÈ¿ÛÂÈ ÛÙÔÈ¯Â›· Û¯ÂÙÈÎ¿ ÌÂ ÙË ‰È·ÌfiÚÊˆÛË ÂÓfi˜Ô‰ÔÓÙÈ·ÙÚÂ›Ô˘ ÁÈ· ÙË ‰ÈÂ˘ÎfiÏ˘ÓÛË ÚfiÛ‚·ÛË˜ Î·È ·ÚÔ¯‹˜ ıÂÚ·Â›·˜ ÛÙ· AMÂA. T· ¿ÙÔÌ· ·˘Ù¿ Ù·ÍÈÓÔÌÔ‡ÓÙ·È ·Ó¿ÏÔÁ· ÌÂ ÙÔ ‚·ıÌfi ·˘ÙÔÂÍ˘ËÚ¤ÙËÛ‹˜ ÙÔ˘˜ Î·È ÙÔ ÛˆÌ·ÙÈ-Îfi, ÓÔËÙÈÎfi, „˘¯ÔÏÔÁÈÎfi ‹ ÏÂÈÙÔ˘ÚÁÈÎfi ÙÔ˘˜ Úfi‚ÏËÌ·. H ‚È‚ÏÈÔÁÚ·Ê›· Û˘ÌÊˆÓÂ› Û¯Â‰fiÓ Ô-ÌfiÊˆÓ· ÛÙÔ ÁÂÁÔÓfi˜ fiÙÈ Ù· AMÂA ¤¯Ô˘Ó ÌÂÁ¿ÏË ·Ó¿ÁÎË ÁÈ· Ô‰ÔÓÙÈ·ÙÚÈÎ‹ ıÂÚ·Â›·. T· ·Ô-ÙÂÏ¤ÛÌ·Ù· ÙË˜ ÌÂÏ¤ÙË˜ Ô˘ Ú·ÁÌ·ÙÔÔÈ‹ıËÎÂ ÛÙË ¯ÒÚ· Ì·˜ ˘Ô‰ÂÈÎÓ‡Ô˘Ó fiÙÈ Ô ÁÂÓÈÎfi˜ Ô-‰ÔÓÙ›·ÙÚÔ˜ Â›Ó·È ·˘Ùfi˜ Ô˘ Î·ÏÂ›Ù·È Ó· ıÂÚ·Â‡ÛÂÈ Û˘¯Ó¿ Ù· AMÂA. EÓÙÔ‡ÙÔÈ˜, ÂÓÒ Â›Ó·È Úfi-ı˘ÌÔ˜, ‰ÂÓ ¤¯ÂÈ ÂÎ·È‰Â˘ÙÂ› ÛÙË ıÂÚ·Â›· ÙˆÓ ·ÙfiÌˆÓ ·˘ÙÒÓ. ŒÙÛÈ ÏÔÈfiÓ, Â›Ó·È ··Ú·›ÙËÙËË ÂÎ·›‰Â˘ÛË ÙˆÓ Ô‰ÔÓÙÈ¿ÙÚˆÓ ÛÙËÓ Ô‰ÔÓÙÈ·ÙÚÈÎ‹ ıÂÚ·Â›· ÙˆÓ AMÂA ÙfiÛÔ Î·Ù¿ ÙË ‰È¿ÚÎÂÈ·ÙˆÓ ÚÔ- Î·È ÌÂÙ·-Ù˘¯È·ÎÒÓ ÙÔ˘˜ ÛÔ˘‰ÒÓ fiÛÔ Î·È ÌÂ ÙË ‰È·-‚›Ô˘ Ì¿ıËÛË. H ‰ÈÂ˘ÎfiÏ˘ÓÛË ÙË˜ ÌÂÙ·Î›ÓËÛË˜ Î·È ÚfiÛ‚·ÛË˜ ÙˆÓ ÂÌÔ‰È˙fiÌÂÓˆÓ ·ÙfiÌˆÓ Ú¤ÂÈ Ó· Ï·Ì-‚¿ÓÂÙ·È ˘fi„Ë Î·Ù¿ ÙÔ Û¯Â‰È·ÛÌfi ÂÓfi˜ Û‡Á¯ÚÔÓÔ˘ Ô‰ÔÓÙÈ·ÙÚÂ›Ô˘ Ô˘ ÙÔ˘˜ ·Ú¤¯ÂÈ ıÂÚ·-Â›·. H ·ÚÔ¯‹ Ô‰ÔÓÙÈ·ÙÚÈÎÒÓ ˘ËÚÂÛÈÒÓ ÛÙÔ˘˜ ÂÈ‰ÈÎÔ‡˜ ·ÛıÂÓÂ›˜ Â›Ó·È ·‰‡Ó·ÙË ¯ˆÚ›˜ ÙÔÓÂÈ‰ÈÎfi ÂÍÔÏÈÛÌfi Ô˘ ÂÍ·ÛÊ·Ï›˙ÂÈ ÙËÓ Â˘ÎÔÏfiÙÂÚË Î·È ·ÛÊ·Ï¤ÛÙÂÚË Ô‰ÔÓÙÈ·ÙÚÈÎ‹ ·ÓÙÈÌÂÙÒ-ÈÛ‹ ÙÔ˘˜. K·ıÒ˜ Ô ·ÚÈıÌfi˜ ÙˆÓ AMÂA Ô˘ ·Ó·˙ËÙÔ‡Ó Ô‰ÔÓÙÈ·ÙÚÈÎ‹ ÊÚÔÓÙ›‰· ·˘Í¿ÓÂÙ·È Û˘-ÓÂ¯Ò˜, Ë Û˘ÓÂÚÁ·Û›· ÙÔ˘ ÁÂÓÈÎÔ‡ Ô‰ÔÓÙ›·ÙÚÔ˘ ÌÂ ÙÔÓ ·È‰Ô‰ÔÓÙ›·ÙÚÔ Î·È ÌÂ ¿ÏÏÂ˜ ÂÈ‰ÈÎfiÙË-ÙÂ˜ Â›Ó·È ··Ú·›ÙËÙË ÁÈ· ÙËÓ ·ÚÔ¯‹ ıÂÚ·Â›·˜ ÛÙ· ¿ÙÔÌ· ·˘Ù¿.


§¤ÍÂÈ˜ ÎÏÂÈ‰È¿: ÛÙ¿ÛË Ô‰ÔÓÙÈ¿ÙÚˆÓ, ÛÙÔÌ·ÙÈÎ‹ ˘ÁÂ›·, ¿ÙÔÌ· ÌÂ ÂÈ‰ÈÎ¤˜ ·Ó¿ÁÎÂ˜, ÂÎ·›‰Â˘ÛË, ·ÚÔ¯‹ ıÂÚ·Â›·˜, ÚfiÛ‚·ÛË

* §¤ÎÙÔÚ·˜ ¶·È‰Ô‰ÔÓÙÈ·ÙÚÈÎ‹˜ EK¶A, MScD, PhD

ÿ‰Ú˘Ì· ÚÔ¤ÏÂ˘ÛË˜:EÚÁ·ÛÙ‹ÚÈÔ ¶·È‰Ô‰ÔÓÙÈ·ÙÚÈÎ‹˜ EK¶A

H ÂÚÁ·Û›· ·ÚÔ˘ÛÈ¿ÛıËÎÂ ˆ˜ ÂÈÛ‹ÁËÛË ÛÙÔ 4Ô ¶·ÓÂÏÏ‹ÓÈÔ ™˘-Ó¤‰ÚÈÔ NÔÛÔÎÔÌÂÈ·Î‹˜ O‰ÔÓÙÈ·ÙÚÈÎ‹˜ 30/9 - 2/10/2011, Aı‹Ó·

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fiÚÔ˜ Ô˘ ·Ó·Ê¤ÚÂÙ·È ÛÙËÓ ·Ó·ËÚ›· (impairment) Î·ÈÛÙÔ˘˜ ÂÚÈÔÚÈÛÌÔ‡˜ Ô˘ ·ÓÙÈÌÂÙˆ›˙Ô˘Ó Ù· AMÂA ÛÙÈ˜‰Ú·ÛÙËÚÈfiÙËÙ¤˜ ÙÔ˘˜ Î·È ÛÙË Û˘ÌÌÂÙÔ¯‹ ÙÔ˘˜ ÛÙË Î·-ıËÌÂÚÈÓfiÙËÙ·. H ·Ó·ËÚ›·, ·ÊÔÚ¿ ¤Ó· ‹ ÂÚÈÛÛfiÙÂÚ·ÚÔ‚Ï‹Ì·Ù· ÙË˜ ÏÂÈÙÔ˘ÚÁ›·˜ ÙÔ˘ ÔÚÁ·ÓÈÛÌÔ‡, ÂÓÒ, ÔÂÚÈÔÚÈÛÌfi˜ ÛÙË ‰Ú·ÛÙËÚÈfiÙËÙ·, ·ÊÔÚ¿ ÙË ‰˘ÛÎÔÏ›·Ô˘ ·ÓÙÈÌÂÙˆ›˙ÂÈ ÙÔ ¿ÙÔÌÔ ÛÙËÓ ÂÎÙ¤ÏÂÛË Ì›·˜ Ú¿ÍË˜Î·È Î·Ù¿ Û˘Ó¤ÂÈ· ÛÙË Û˘ÌÌÂÙÔ¯‹ ÙÔ˘ ÛÙËÓ Î·ıËÌÂÚÈÓ‹˙ˆ‹3. ŒÙÛÈ, Ô Â˘Ú‡˜ fiÚÔ˜ “¿ÙÔÌÔ ÌÂ ÂÈ‰ÈÎ¤˜ ·Ó¿ÁÎÂ˜”·Ó·Ê¤ÚÂÙ·È ÛÙÔ ¿ÙÔÌÔ Ô˘ Ë Ê˘ÛÈÔÏÔÁÈÎ‹ ÙÔ˘ ·Ó¿Ù˘-ÍË, ÎÔÈÓˆÓÈÎ‹ ¤ÎÊÚ·ÛË, ÂÚÁ·Û›· Î·È „˘¯·ÁˆÁ›· ·Ú·-ÎˆÏ‡ÂÙ·È ÁÈ· ÌÂÁ¿ÏÔ ¯ÚÔÓÈÎfi ‰È¿ÛÙËÌ· ÂÍ·ÈÙ›·˜ ÂÓfi˜ÛˆÌ·ÙÈÎÔ‡, ÓÔËÙÈÎÔ‡, „˘¯ÔÏÔÁÈÎÔ‡ ‹ ÏÂÈÙÔ˘ÚÁÈÎÔ‡ ÚÔ-‚Ï‹Ì·ÙÔ˜4.T· AMÂA Ù·ÍÈÓÔÌÔ‡ÓÙ·È ·Ó¿ÏÔÁ· ÌÂ ÙÔ ‚·ıÌfi ·˘ÙÔÂÍ˘-ËÚ¤ÙËÛ‹˜ ÙÔ˘˜ Î·È ÙÔ ÛˆÌ·ÙÈÎfi, ÓÔËÙÈÎfi, „˘¯ÔÏÔÁÈÎfi‹ ÏÂÈÙÔ˘ÚÁÈÎfi ÙÔ˘˜ Úfi‚ÏËÌ·4. ™‡ÌÊˆÓ· ÌÂ ÙÔ ÙÂÏÂ˘-Ù·›Ô ‰È·¯ˆÚÈÛÌfi, Ù· AMÂA Ù·ÍÈÓÔÌÔ‡ÓÙ·È ÛÂ ¿ÙÔÌ· ÌÂ: ·) XÚfiÓÈÔ È·ÙÚÈÎfi Úfi‚ÏËÌ·: Î·Ú‰ÈÔ¿ıÂÈÂ˜, ÓfiÛÔÈ ÙÔ˘·›Ì·ÙÔ˜, ÌÂÙ·‚ÔÏÈÎ¤˜ ÓfiÛÔÈ, ÓfiÛÔÈ ÙÔ˘ ·ÓÔÛÔÔÈËÙÈÎÔ‡Û˘ÛÙ‹Ì·ÙÔ˜, ÓfiÛÔÈ ÙÔ˘ ·Ó·ÓÂ˘ÛÙÈÎÔ‡ Û˘ÛÙ‹Ì·ÙÔ˜, Î·Ú-Î›ÓÔ˜ Î. ¿.‚) ™ˆÌ·ÙÈÎ‹ ·Ó·ËÚ›· (ÂÌÔ‰È˙fiÌÂÓ· ¿ÙÔÌ·): Û˘ÁÁÂ-Ó‹˜/Â›ÎÙËÙË ·ÒÏÂÈ· ·ÚÙÈÌ¤ÏÂÈ·˜, ·ı‹ÛÂÈ˜ ÙÔ˘ Ì˘Ô-ÛÎÂÏÂÙÈÎÔ‡ Û˘ÛÙ‹Ì·ÙÔ˜ (·ÚıÚ›ÙÈ‰·, Ì˘˚Î‹ ‰˘ÛÙÚÔÊ›·,Ì˘·Ûı¤ÓÂÈ· Gravis, osteogenesis imperfecta), ·ı‹ÛÂÈ˜ÙÔ˘ ÓÂ˘ÚÔÌ˘ÈÎÔ‡ Û˘ÛÙ‹Ì·ÙÔ˜ (ÂÁÎÂÊ·ÏÈÎ‹ ·Ú¿Ï˘ÛË,ÛÎÏ‹Ú˘ÓÛË Î·Ù¿ Ï¿Î·˜) Î·È ÔÏÈÎ‹ ‹ ÌÂÚÈÎ‹ ·ÒÏÂÈ·fiÚ·ÛË˜ ‹/Î·È ·ÎÔ‹˜.Á) ™˘ÌÂÚÈÊÂÚÈÔÏÔÁÈÎ¤˜ ‰È·Ù·Ú·¯¤˜: ÓÔËÙÈÎ‹ ˘ÛÙ¤ÚË-ÛË, Û˘Ó·ÈÛıËÌ·ÙÈÎ¤˜, „˘¯ÔÏÔÁÈÎ¤˜ Î·È „˘¯È·ÙÚÈÎ¤˜ ‰È·-Ù·Ú·¯¤˜, Ì·ıËÛÈ·Î¤˜ ‰˘ÛÎÔÏ›Â˜ (‰˘ÛÏÂÍ›·, ‰˘Û·ÚÈı-ÌËÛ›·, ‰˘Û·Ó·ÁÓˆÛ›·), ÓÂ‡ÚˆÛË, ÂÏÏÂÈÌÌ·ÙÈÎ‹ ÚÔÛÔ-¯‹-˘ÂÚÎÈÓËÙÈÎfiÙËÙ· (ADHD- attention deficit hyperactivitydisorder), ·˘ÙÈÛÌfi˜, „‡¯ˆÛË. ‰) ™˘ÁÁÂÓ‹ ‹ Â›ÎÙËÙ· Û‡Ó‰ÚÔÌ· ‹ ÚÔ‚Ï‹Ì·Ù· ÛÙËÁÓ·ıÔÚÔÛˆÈÎ‹ ¯ÒÚ·: ¿ÙÔÌ· ÌÂ ·ÙÂÏ‹ ·‰·Ì·ÓÙÈÓÔ-ÁÂÓÂÛ›·, ·ÙÂÏ‹ Ô‰ÔÓÙÈÓÔÁÂÓÂÛ›·, ¯ÂÈÏÂÔ-, ÁÓ·ıÔ-, ˘Â-ÚˆÈÔ- Û¯ÈÛÙ›Â˜, Î·ÚÎ›ÓÔ ÙÔ˘ ÛÙfiÌ·ÙÔ˜ Î.¿. ™Â fiÏÂ˜ ÙÈ˜ ·Ó·Ù˘ÁÌ¤ÓÂ˜ ¯ÒÚÂ˜ Ô Ì¤ÛÔ˜ fiÚÔ˜ ˙ˆ‹˜ÙˆÓ AMÂA ·˘Í¿ÓÂÙ·È Û˘ÓÂ¯Ò˜ Î·ıÒ˜ ‚ÂÏÙÈÒÓÂÙ·È Ë ÔÈ-fiÙËÙ· ˙ˆ‹˜, ÂÍÂÏ›ÛÛÂÙ·È Ë È·ÙÚÈÎ‹ Î·È Ë ÙÂ¯ÓÔÏÔÁ›·, Î·ÈÂÓı·ÚÚ‡ÓÔÓÙ·È ÔÈ ÚÔÛ¿ıÂÈÂ˜ ÁÈ· ÙËÓ ÎÔÈÓˆÓÈÎ‹ ¤ÓÙ·-ÍË ·˘ÙÒÓ ÙˆÓ ·ÙfiÌˆÓ. K·Ù¿ Û˘Ó¤ÂÈ· Ô ·ÚÈıÌfi˜ ÙˆÓ·ÙfiÌˆÓ ·˘ÙÒÓ Ô˘ ·Ó·˙ËÙ¿ ·ÓÙÈÌÂÙÒÈÛË Î·È ÊÚÔÓÙ›‰·ÛÙÔ Ô‰ÔÓÙÈ·ÙÚÂ›Ô Û˘ÓÂ¯Ò˜ ı· ·˘Í¿ÓÂÙ·È, ÁÂÁÔÓfi˜ Ô˘Î·ıÈÛÙ¿ ·ÔÏ‡Ùˆ˜ ·Ó·ÁÎ·›· ÙË ÁÓÒÛË Î·È ÂÍÂÈ‰›ÎÂ˘ÛËÙÔ˘ Ô‰ÔÓÙÈ¿ÙÚÔ˘ ÛÙËÓ ·ÓÙÈÌÂÙÒÈÛ‹ ÙÔ˘˜.

™TOMATIKH Y°EIAAÚÎÂÙ¤˜ ÌÂÏ¤ÙÂ˜ ¤¯Ô˘Ó ÂÚÈÁÚ¿„ÂÈ ÙË ÛÙÔÌ·ÙÈÎ‹ ˘ÁÂ›·ÙˆÓ AMÂA. T· Â˘Ú‹Ì·Ù¿ ÙÔ˘˜ Û˘ÌÊˆÓÔ‡Ó ÛÙÔ ÁÂÁÔÓfi˜fiÙÈ Ë ÛÙÔÌ·ÙÈÎ‹ ̆ ÁÂ›· ÙˆÓ ·ÙfiÌˆÓ ·˘ÙÒÓ Î·È Î˘Ú›ˆ˜ ÙˆÓ·ÙfiÌˆÓ ÌÂ ÓÔËÙÈÎ‹ ˘ÛÙ¤ÚËÛË Â›Ó·È ¯ÂÈÚfiÙÂÚË ·fi ÙÔ˘˜

˘ÁÈÂ›˜ Û˘ÓÔÌ‹ÏÈÎÔ‡˜ ÙÔ˘˜5-7. ¶·Ú¿ÌÂÙÚÔÈ fiˆ˜ ÔÈ ‰˘-ÛÎÔÏ›Â˜ ÛÙË ‰ÈÂÍ·ÁˆÁ‹ ÙË˜ ÛÙÔÌ·ÙÈÎ‹˜ ˘ÁÈÂÈÓ‹˜, Ë Ï‹-„Ë Ê·ÚÌ¿ÎˆÓ, Ù· ÔÚıÔ‰ÔÓÙÈÎ¿ ÚÔ‚Ï‹Ì·Ù·, Ë ÛÙÔÌ·-ÙÈÎ‹ ·Ó·ÓÔ‹, ÔÈ ‰˘ÛÎÔÏ›Â˜ ÛÙË Ì¿ÛËÛË Î·È Ë Î·Ù·Ó¿-ÏˆÛË Ì·Ï·ÎÒÓ ÙÚÔÊÒÓ Û˘Ì‚¿ÏÏÔ˘Ó ·ÚÓËÙÈÎ¿ ÛÙË ÛÙÔ-Ì·ÙÈÎ‹ Î·Ù¿ÛÙ·ÛË8-9. ™‡ÌÊˆÓ· ÌÂ ÙË ‚È‚ÏÈÔÁÚ·Ê›·, Ù·¿ÙÔÌ· ÌÂ ÂÈ‰ÈÎ¤˜ ·Ó¿ÁÎÂ˜ ·ÚÔ˘ÛÈ¿˙Ô˘Ó Ô˘Ï›ÙÈ‰· ‹/Î·ÈÂÚÈÔ‰ÔÓÙ›ÙÈ‰· ÈÔ Û˘¯Ó¿ ·fi Ù· ̆ ÁÈ‹ ¿ÙÔÌ·, ÂÓÒ Ù· Â˘-Ú‹Ì·Ù· ÁÈ· ÙÔÓ ÂÈÔÏ·ÛÌfi ÙË˜ ÙÂÚË‰fiÓ·˜ Â›Ó·È ·ÓÙÈ-Ê·ÙÈÎ¿10-13. EÈÏ¤ÔÓ, Ù· ¿ÙÔÌ· ÌÂ ÂÈ‰ÈÎ¤˜ ·Ó¿ÁÎÂ˜ ÂÌ-Ê·Ó›˙Ô˘Ó Û˘¯Ó¿ ·ÓÔÈ¯Ù‹ ‰‹ÍË, ÛÙ·˘ÚÔÂÈ‰‹ Û‡ÁÎÏÂÈÛË,˘ÂÚ¿ÚÈıÌ· ‹ ÂÏÏÂ›ÔÓÙ· ‰fiÓÙÈ·, ¤ÎÙÔË ·Ó·ÙÔÏ‹ ‰Ô-ÓÙÈÒÓ Î.¿.14-15. H ·ÍÈÔÏfiÁËÛË ÙˆÓ ·ÔÙÂÏÂÛÌ¿ÙˆÓ ÙˆÓÚÔ·Ó·ÊÂÚı¤ÓÙˆÓ ÌÂÏÂÙÒÓ ı· Ú¤ÂÈ ‚¤‚·È· Ó· Á›ÓÂ-Ù·È ÌÂ ÚÔÛÔ¯‹ ·ÊÔ‡ Û˘¯Ó¿ ·˘Ù¤˜ ·ÊÔÚÔ‡Ó ‰Â›ÁÌ· ·Ùfi-ÌˆÓ ÌÂ ÌÈÎÚfi Ì¤ÁÂıÔ˜, ‰È·ÊÔÚÂÙÈÎ¤˜ ·Ó·ËÚ›Â˜ / Û‡Ó-‰ÚÔÌ· Î·ıÒ˜ Î·È ‰È·ÊÔÚÂÙÈÎ¤˜ Û˘Óı‹ÎÂ˜ ‰È·‚›ˆÛË˜.ŒÛÙˆ fiÌˆ˜ Î·È ÌÂ ÙËÓ ·Ú·¿Óˆ ÂÈÊ‡Ï·ÍË, Ë ‚È‚ÏÈÔ-ÁÚ·Ê›· ‰Â›¯ÓÂÈ fiÙÈ ˘¿Ú¯ÂÈ ÌÂÁ¿ÏË ·Ó¿ÁÎË ÁÈ· ÂÚÈÔ-‰ÔÓÙÈÎ‹, Ô‰ÔÓÙÈÎ‹ Î·È ÔÚıÔ‰ÔÓÙÈÎ‹ ıÂÚ·Â›· ÛÂ ·˘Ù‹ ÙËÓÔÌ¿‰· ÏËı˘ÛÌÔ‡6. OÈ Î‡ÚÈÔÈ ·Ú¿ÁÔÓÙÂ˜ Ô˘ Û˘Ì‚¿ÏÏÔ˘Ó ÛÙË ¯·ÌËÏ‹ ·-ÚÔ¯‹ Ô‰ÔÓÙÈ·ÙÚÈÎ‹˜ ıÂÚ·Â›·˜ Â›Ó·È ÔÈ ·ÎfiÏÔ˘ıÔÈ: ·) Ë·Ó·˙‹ÙËÛË ÊÚÔÓÙ›‰·˜ ÛÂ ·ÚÎÂÙ¿ ÚÔ¯ˆÚËÌ¤ÓÔ ÛÙ¿‰ÈÔÙË˜ ÙÂÚË‰fiÓ·˜/ÂÚÈÔ‰ÔÓÙÈÎ‹˜ ÓfiÛÔ˘, ‚) ÔÈ ‰˘ÛÎÔÏ›Â˜ÛÙËÓ ·ÚÔ¯‹ Ô‰ÔÓÙÈ·ÙÚÈÎ‹˜ ıÂÚ·Â›·˜ (fiˆ˜ ‰‡ÛÎÔÏËÚfiÛ‚·ÛË ÛÙÔ Ô‰ÔÓÙÈ·ÙÚÂ›Ô, ÂÏÏÈ‹˜ ÂÍÔÏÈÛÌfi˜, ÂÏÏÈ-‹˜ ÂÎ·›‰Â˘ÛË ÙÔ˘ Ô‰ÔÓÙÈ¿ÙÚÔ˘, ·ÓÂ·ÚÎ‹˜ Î¿Ï˘„ËÙË˜ Ô‰ÔÓÙÈ·ÙÚÈÎ‹˜ ıÂÚ·Â›·˜ ·fi ÙÔ˘˜ ·ÛÊ·ÏÈÛÙÈÎÔ‡˜ÊÔÚÂ›˜/ÔÈÎÔÓÔÌÈÎ¿ ÚÔ‚Ï‹Ì·Ù· Î.·.), Á) ÔÈ ‰˘ÛÎÔÏ›Â˜ÛÙËÓ ÂÈÎÔÈÓˆÓ›· (ÓÔËÙÈÎ‹ ˘ÛÙ¤ÚËÛË), ‰) Ë ÂÚÈÔÚÈÛÌ¤-ÓË ·ÚÔ¯‹ Ô‰ÔÓÙÈ·ÙÚÈÎ‹˜ ÊÚÔÓÙ›‰·˜ ÛÂ ÓÔÛÔÎÔÌÂ›· ÌÂÛ˘Óı‹ÎÂ˜ ÁÂÓÈÎ‹˜ ·Ó·ÈÛıËÛ›·˜16-18. H Û˘ÛÛÒÚÂ˘ÛË ÙˆÓ ·ıÂÚ¿Â˘ÙˆÓ ÛÙÔÌ·ÙÈÎÒÓ ÓfiÛˆÓfiˆ˜ ÙË˜ ÙÂÚË‰fiÓ·˜ Î·È ÙˆÓ ÓfiÛˆÓ ÙÔ˘ ÂÚÈÔ‰ÔÓÙ›Ô˘ÛÂ Û˘Ó‰˘·ÛÌfi ÌÂ ÙÔ˘˜ ÚÔ·Ó·ÊÂÚı¤ÓÙÂ˜ ·Ú¿ÁÔÓÙÂ˜,ÌÂÙ·ÙÚ¤ÂÈ ÙËÓ ·ÚÔ¯‹ Ô‰ÔÓÙÈ·ÙÚÈÎ‹˜ ıÂÚ·Â›·˜ ÁÈ· Ù·¿ÙÔÌ· ÌÂ ÂÈ‰ÈÎ¤˜ ·Ó¿ÁÎÂ˜, ÛÂ ÚfiÎÏËÛË. ™ÙËÓ EÏÏ¿‰·, Ì¤¯ÚÈ ÙÒÚ·, ¤¯Ô˘Ó Á›ÓÂÈ Ï›ÁÂ˜ ÌÂÏ¤ÙÂ˜ Û¯Â-ÙÈÎ¿ ÌÂ ÙË ÛÙÔÌ·ÙÈÎ‹ ˘ÁÂ›·, ÙËÓ Ô‰ÔÓÙÈ·ÙÚÈÎ‹ ıÂÚ·Â›·Î·È ÙÈ˜ Ô‰ÔÓÙÈ·ÙÚÈÎ¤˜ ·Ó¿ÁÎÂ˜ ÙˆÓ AMÂA. AÓ·ÊÔÚÈÎ¿ ÌÂÙËÓ ·ÚÔ¯‹ Ô‰ÔÓÙÈ·ÙÚÈÎ‹˜ ÂÚ›ı·Ï„Ë˜ ¤¯ÂÈ ‚ÚÂıÂ› fiÙÈÌfiÓÔ ÙÔ 1/10 ¤ˆ˜ Î·È 1/4 ÙˆÓ ÙÂÚË‰ÔÓÈÛÌ¤ÓˆÓ Ô‰ÔÓÙÈ-ÎÒÓ ÂÈÊ·ÓÂÈÒÓ ¤¯Ô˘Ó ıÂÚ·Â˘ÙÂ› ÛÂ ·È‰È¿ Î·È ÂÊ‹-‚Ô˘˜ ÌÂ ÓÔËÙÈÎ‹ ˘ÛÙ¤ÚËÛË19-20.°È· ÙÔÓ ÛÎÔfi ·˘Ùfi, Ú·ÁÌ·ÙÔÔÈ‹ıËÎÂ ÌÂÏ¤ÙË ·fi ÙÔEÚÁ·ÛÙ‹ÚÈÔ ÙË˜ ¶·È‰Ô‰ÔÓÙÈ·ÙÚÈÎ‹˜ EK¶A ÛÂ Û˘ÓÂÚÁ·-Û›· ÌÂ ÙËÓ EÏÏËÓÈÎ‹ O‰ÔÓÙÈ·ÙÚÈÎ‹ OÌÔÛÔÓ‰›·21, ÌÂ ÛÙfi-¯Ô Ó·: ñ ÂÚÈÁÚ¿„ÂÈ ÙËÓ Ô‰ÔÓÙÈ·ÙÚÈÎ‹ ÊÚÔÓÙ›‰· ÙË˜ ÛÙÔÌ·ÙÈ-

Î‹˜ ˘ÁÂ›·˜ ·ÙfiÌˆÓ ÌÂ ÛˆÌ·ÙÈÎ‹ Î·È/‹ ÓÔËÙÈÎ‹ ‰È·Ù·-Ú·¯‹ (™N¢) ÛÙËÓ EÏÏ¿‰·.

ñ ÂÍÂÚÂ˘Ó‹ÛÂÈ ÙÔ ÚÔÊ›Ï Ô‰ÔÓÙÈ¿ÙÚˆÓ Ô˘ ·Ú¤¯Ô˘ÓÔ‰ÔÓÙÈ·ÙÚÈÎ‹ ÊÚÔÓÙ›‰· ÛÂ ·˘Ù¿ Ù· ¿ÙÔÌ·.

ñ Î·Ù·ÁÚ¿„ÂÈ ÙÈ˜ ·fi„ÂÈ˜ Î·È ÛÙ¿ÛÂÈ˜ ÙˆÓ Ô‰ÔÓÙÈ¿-

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ÙÚˆÓ Û¯ÂÙÈÎ¿ ÌÂ ÙËÓ ·ÚÔ¯‹ Ô‰ÔÓÙÈ·ÙÚÈÎ‹˜ ÊÚÔÓÙ›-‰·˜ ÛÙË Û˘ÁÎÂÎÚÈÌ¤ÓË ÔÌ¿‰· ·ÛıÂÓÒÓ.

¢Â›ÁÌ· ÌÂÏ¤ÙË˜ O ·Ú¯ÈÎfi˜ ÛÙfi¯Ô˜ ÙÔ˘ ÏËı˘ÛÌÈ·ÎÔ‡ ‰Â›ÁÌ·ÙÔ˜ ‹Ù·Ó ÔÈÔ‰ÔÓÙ›·ÙÚÔÈ Ô˘ ·Ú·ÎÔÏÔ‡ıËÛ·Ó ÙÔ 26Ô ¶·ÓÂÏÏ‹ÓÈÔO‰ÔÓÙÈ·ÙÚÈÎfi ™˘Ó¤‰ÚÈÔ ÛÙËÓ Aı‹Ó· (2007). MÂ ÙËÓ ÙÂ-¯ÓÈÎ‹ ÂÈÏÔÁ‹˜ Ù˘¯·›Ô˘ ‰Â›ÁÌ·ÙÔ˜, Û˘ÌÌÂÙÂ›¯·Ó ÙÂÏÈÎ¿534/750 Ô‰ÔÓÙ›·ÙÚÔÈ ·Ú·ÎÔÏÔ˘ıÔ‡ÓÙÂ˜ (56% Á˘Ó·›ÎÂ˜Î·È 44% ¿Ó‰ÚÂ˜). °È· ÙÔ ÛÎÔfi ·˘Ùfi ¯ÚËÛÈÌÔÔÈ‹ıËÎÂ¤Ó· ÂÚˆÙËÌ·ÙÔÏfiÁÈÔ Ô˘ ÚÔ‹ÏıÂ ·fi ÙË ÙÚÔÔÔ›ËÛËÂÎÂ›ÓÔ˘ Ô˘ ¯ÚËÛÈÌÔÔÈ‹ıËÎÂ ÛÙË ÌÂÏ¤ÙË ÙˆÓ Bedi Î·ÈÛ˘Ó (2001)17. TÔ ÂÚˆÙËÌ·ÙÔÏfiÁÈÔ ·˘Ùfi ÌÂÙ·ÊÚ¿ÛÙËÎÂ,ÂÏ¤Á¯ıËÎÂ ÁÈ· ÙËÓ ÂÁÎ˘ÚfiÙËÙ· Î·È ÙËÓ ·ÍÈÔÈÛÙ›· ÙÔ˘ Î·ÈÙÚÔÔÔÈ‹ıËÎÂ Î·Ù¿ÏÏËÏ· ÁÈ· ÙËÓ ÂÊ·ÚÌÔÁ‹ ÙÔ˘ ÛÙ·ÂÏÏËÓÈÎ¿ Ï·›ÛÈ·.

EÚˆÙËÌ·ÙÔÏfiÁÈÔTÔ ÂÚˆÙËÌ·ÙÔÏfiÁÈÔ ·ÔÙÂÏÂ›ÙÔ ·fi Ù¤ÛÛÂÚÈ˜ ÂÓfiÙËÙÂ˜Î·È Û˘Ó¤ÏÂÍÂ ÛÙÔÈ¯Â›· Û¯ÂÙÈÎ¿ ÌÂ Ù· ‰ËÌÔÁÚ·ÊÈÎ¿ Î·ÈÎÔÈÓˆÓÈÎÔ-ÔÈÎÔÓÔÌÈÎ¿ ÛÙÔÈ¯Â›· Ô‰ÔÓÙÈ¿ÙÚˆÓ (ËÏÈÎ›·, Ê‡-ÏÔ, ÚÔ-/ÌÂÙ·-Ù˘¯È·Î¤˜ ÛÔ˘‰¤˜), ÙÔ Â›‰Ô˜ ÙÔ˘ Ô‰Ô-ÓÙÈ·ÙÚÂ›Ô˘ (ÁÂÓÈÎ‹ Ô‰ÔÓÙÈ·ÙÚÈÎ‹/ ÂÈ‰ÈÎfiÙËÙ·, ÙÔÔıÂÛ›·,‡·ÚÍË ‚ÔËıÔ‡ Ô‰ÔÓÙÈ·ÙÚÂ›Ô˘), ÙËÓ ·ÚÔ¯‹ Ô‰ÔÓÙÈ·-ÙÚÈÎ‹˜ ıÂÚ·Â›·˜ ÛÂ ¿ÙÔÌ· ÌÂ ÛˆÌ·ÙÈÎ‹/ÓÔËÙÈÎ‹ ‰È·Ù·-Ú·¯‹ (Û˘¯ÓfiÙËÙ·, Â›‰Ô˜, ‰˘ÛÎÔÏ›Â˜ Ô˘ ·ÓÙÈÌÂÙˆ›˙ÂÈ ÔÔ‰ÔÓÙ›·ÙÚÔ˜) Î·È ÙÈ˜ ÛÙ¿ÛÂÈ˜ Î·È ·fi„ÂÈ˜ ÙˆÓ Ô‰ÔÓÙÈ¿-ÙÚˆÓ Û¯ÂÙÈÎ¿ ÌÂ ÙËÓ ·ÚÔ¯‹ Ô‰ÔÓÙÈ·ÙÚÈÎ‹˜ ÊÚÔÓÙ›‰·˜ÛÂ ·˘Ù¿ Ù· ¿ÙÔÌ·.

AÔÙÂÏ¤ÛÌ·Ù·¢ËÌÔÁÚ·ÊÈÎ¿ ÛÙÔÈ¯Â›· Ô‰ÔÓÙÈ¿ÙÚˆÓ: T· ·ÔÙÂÏ¤ÛÌ·Ù·¤‰ÂÈÍ·Ó fiÙÈ 60,3% ÙˆÓ Û˘ÌÌÂÙÂ¯fiÓÙˆÓ ¤¯Ô˘Ó ·ÔÊÔÈÙ‹-ÛÂÈ ·fi ÙËÓ O‰ÔÓÙÈ·ÙÚÈÎ‹ ™¯Ô-Ï‹ ÙÔ˘ ¶·ÓÂÈÛÙËÌ›Ô˘ AıËÓÒÓ,24,2% ·fi ÙÔ ¶·ÓÂÈÛÙ‹ÌÈÔ ÙË˜£ÂÛÛ·ÏÔÓ›ÎË˜, 5,7% ·fi ÙËPÔ˘Ì·Ó›· Î·È 9,8% ·fi ¶·ÓÂÈ-ÛÙ‹ÌÈ· ¢˘ÙÈÎÔÂ˘Úˆ·˚ÎÒÓ Î·ÈB·ÏÎ·ÓÈÎÒÓ ¯ˆÚÒÓ. ¶ÂÚ›Ô˘ 7·fi ÙÔ˘˜ 10 Û˘ÌÌÂÙ¤¯ÔÓÙÂ˜ ‰ÂÓÂ›¯·Ó ÂÎ·È‰Â˘ÙÂ› ÛÙË ıÂÚ·Â›··ÙfiÌˆÓ ÌÂ ™N¢. Afi ÙÔ˘˜ Ô‰Ô-ÓÙÈ¿ÙÚÔ˘˜ Ô˘ Â›¯·Ó ÂÎ·È‰Â˘-ÙÂ› ÛÙË ıÂÚ·Â›· ÙˆÓ AMÂA Î·-Ù¿ ÙË ‰È¿ÚÎÂÈ· ÙˆÓ ÌÂÙ·Ù˘¯È·-ÎÒÓ ÙÔ˘˜ ÛÔ˘‰ÒÓ, 26% ‹Ù·Ó·È‰Ô‰ÔÓÙ›·ÙÚÔÈ, 14,4% ÂÚÈÔ-‰ÔÓÙÔÏfiÁÔÈ Î·È 13,7% ÚÔÛıÂ-ÙÔÏfiÁÔÈ. E›‰Ô˜ Ô‰ÔÓÙÈ·ÙÚÂ›Ô˘: H ÏÂÈÔ„Ë-Ê›· ÙˆÓ Û˘ÌÌÂÙÂ¯fiÓÙˆÓ ‹Ù·Ó ÁÂ-ÓÈÎÔ› Ô‰ÔÓÙ›·ÙÚÔÈ Ô˘ ·ÛÎÔ‡Û·ÓÁÂÓÈÎ‹ Ô‰ÔÓÙÈ·ÙÚÈÎ‹ ÛÙÔ È‰ÈˆÙÈÎfiÙÔ˘˜ È·ÙÚÂ›Ô ÛÙËÓ Â˘Ú‡ÙÂÚË Â-ÚÈÔ¯‹ ÙˆÓ AıËÓÒÓ. §ÈÁfiÙÂÚÔ ·fi

50% ÙˆÓ Ô‰ÔÓÙÈ¿ÙÚˆÓ ÚÔÛ¤ÊÂÚ·Ó ÙÈ˜ ̆ ËÚÂÛ›Â˜ ÙÔ˘˜ ÌÂÙËÓ Ô‰ÔÓÙÈ·ÙÚÈÎ‹ ÙÂÛÛ¿ÚˆÓ ̄ ÂÈÚÒÓ. O Ì¤ÛÔ˜ ·ÚÈıÌfi˜ AMÂAÔ˘ ıÂÚ·Â‡ÔÓÙ·Ó ·Ó¿ ¤ÙÔ˜ ‹Ù·Ó 8 ¿ÙÔÌ· ÂÓÒ 4/10 Ô‰Ô-ÓÙÈ¿ÙÚÔ˘˜ ·Ú¤ÂÌ·Ó ·˘Ù¿ Ù· ¿ÙÔÌ· ÛÂ ÂÍÂÈ‰ÈÎÂ˘Ì¤ÓÔ˘˜Ô‰ÔÓÙÈ¿ÙÚÔ˘˜.¶·ÚÂ¯fiÌÂÓË ıÂÚ·Â›·: TÔ Â›‰Ô˜ ÙË˜ Ô‰ÔÓÙÈ·ÙÚÈÎ‹˜ ıÂ-Ú·Â›·˜ Ô˘ ·ÚÂ›¯ÂÙÔ ÈÔ Û˘¯Ó¿ ‹Ù·Ó Ô Î·ı·ÚÈÛÌfi˜ÙˆÓ ‰ÔÓÙÈÒÓ (65,2%) Î·È ÛÙË Û˘Ó¤¯ÂÈ· ÔÈ ·ÔÎ·Ù·ÛÙ¿-ÛÂÈ˜, Ë ÂÊ·ÚÌÔÁ‹ ÊıÔÚ›Ô˘ Î·È ÔÈ ÂÍ·ÁˆÁ¤˜ ‰ÔÓÙÈÒÓ. HÔ‰ÔÓÙÈ·ÙÚÈÎ‹ ıÂÚ·Â›· Ô˘ ·ÚÂ›¯ÂÙÔ ÏÈÁfiÙÂÚÔ Û˘¯Ó¿‹Ù·Ó Ë ÔÚıÔ‰ÔÓÙÈÎ‹ (¶›Ó. 1) Î·È ̄ ·Ú·ÎÙËÚ›ÛÙËÎÂ ·fi ÙÔ˘˜ÂÚˆÙËı¤ÓÙÂ˜ Ô‰ÔÓÙÈ¿ÙÚÔ˘˜ ˆ˜ Ë ÈÔ ‰‡ÛÎÔÏË ıÂÚ·Â›·(78,4%). ™ÙÔ ‚·ıÌfi ‰˘ÛÎÔÏ›·˜ ·ÎÔÏÔ‡ıËÛ·Ó Ë ÚÔÛıÂ-ÙÈÎ‹ ·ÔÎ·Ù¿ÛÙ·ÛË Î·È Ë ·ÓÙÈÌÂÙÒÈÛË Ô‰ÔÓÙÈÎÔ‡ ÙÚ·‡-Ì·ÙÔ˜ (62,9% Î·È 45,9% ·ÓÙ›ÛÙÔÈ¯·, ¶›Ó. 2). OÈ ·ÈÙ›Â˜ Ô˘·Ó·Ê¤ÚıËÎ·Ó ÈÔ Û˘¯Ó¿ ·fi ÙÔ˘˜ Ô‰ÔÓÙÈ¿ÙÚÔ˘˜ ̂ ˜ ̆ Â‡-ı˘ÓÂ˜ ÁÈ· ÙËÓ ¤ÏÏÂÈ„Ë ·ÚÔ¯‹˜ ıÂÚ·Â›·˜ ÛÙ· AÌÂA‹Ù·Ó: ‰˘ÛÎÔÏ›Â˜ ÛÙËÓ ÚfiÛ‚·ÛË ÛÙÔ Ô‰ÔÓÙÈ·ÙÚÂ›Ô, ÔÈ-ÎÔÓÔÌÈÎÔ› ÏfiÁÔÈ Î·È Ë ¤ÏÏÂÈ„Ë ÂÈ‰ÈÎ‹˜ ÂÎ·›‰Â˘ÛË˜. ™Ù¿ÛÂÈ˜ Î·È ·fi„ÂÈ˜ ÙˆÓ Ô‰ÔÓÙÈ¿ÙÚˆÓ: ™¯Â‰fiÓ fiÏÔÈ ÔÈÔ‰ÔÓÙ›·ÙÚÔÈ Û˘ÌÊÒÓËÛ·Ó ÛÙËÓ ¿Ô„Ë fiÙÈ ·ÚfiÏÔ Ô˘Ë Ô‰ÔÓÙÈ·ÙÚÈÎ‹ ıÂÚ·Â›· ÙˆÓ AMÂA Â›Ó·È ‰‡ÛÎÔÏË Î·È¯ÚÔÓÔ‚fiÚ·, ÚÔÛÊ¤ÚÂÈ Ù·˘Ùfi¯ÚÔÓ· ËıÈÎ‹ ·ÓÙ·ÌÔÈ‚‹(¶›Ó. 3). T· ·ÔÙÂÏ¤ÛÌ·Ù· ÙË˜ ÌÂÏ¤ÙË˜ ¤‰ÂÈÍ·Ó fiÙÈ Ë ÏÂÈ-Ô„ËÊ›· ÙˆÓ Ô‰ÔÓÙÈ¿ÙÚˆÓ Ô˘ Û˘ÌÌÂÙÂ›¯·Ó ÛÙÔ 26Ô ¶·-ÓÂÏÏ‹ÓÈÔ O‰ÔÓÙÈ·ÙÚÈÎfi Û˘Ó¤‰ÚÈÔ Î·È ÂÚˆÙ‹ıËÎ·Ó, ‹Ù·ÓÚfiı˘ÌÔÈ Î·È ·ÚÂ›¯·Ó ıÂÚ·Â›· ÛÙ· AMÂA ·Ú¿ ÙÔ ÁÂ-ÁÔÓfi˜ fiÙÈ Û¯Â‰fiÓ ÌfiÓÔ 1/3 ÙˆÓ Ô‰ÔÓÙÈ¿ÙÚˆÓ Â›¯·Ó ÂÎ-·È‰Â˘ıÂ› ÛÙËÓ ·ÓÙÈÌÂÙÒÈÛË ·˘Ù‹˜ ÙË˜ ÔÌ¿‰·˜ ·ÛıÂ-ÓÒÓ. ¶·Ú’ fiÏ· ·˘Ù¿ ÌÂÚÈÎ¿ Â›‰Ë Ô‰ÔÓÙÈ·ÙÚÈÎ‹˜ ıÂÚ·Â›-·˜, fiˆ˜ ÔÚıÔ‰ÔÓÙÈÎ‹, ÂÓ‰Ô‰ÔÓÙÈÎ‹ Î·È ÂÚÈÔ‰ÔÓÙÈÎ‹ ıÂ-Ú·Â›· Î·ıÒ˜ Î·È ÚÔÛıÂÙÈÎ‹ ·ÔÎ·Ù¿ÛÙ·ÛË ·Ú¤¯Ô-

67


¶›Ó·Î·˜ 1

™YXNOTHTA ¶APOXH™ ANA ETO™ ¢IAºOPøN EI¢øN O¢ONTIATPIKH™ £EPA¶EIA™ ™E AMÂA

™˘¯ÓfiÙËÙ· ·ÚÔ¯‹˜ ıÂÚ·Â›·˜

AÚÈıÌfi˜ (%)

E›‰Ô˜ ıÂÚ·Â›·˜ ™˘¯Ó¿ ™¿ÓÈ· ¶ÔÙ¤

(≥10 ·ÛıÂÓÂ›˜) (≤ 5 ·ÛıÂÓÂ›˜) (Î·Ó¤Ó·)

K·ı·ÚÈÛÌfi˜ ‰ÔÓÙÈÒÓ 307 (58,0) 164 (30,9) 59 (11,1)AÔÎ·Ù·ÛÙ¿ÛÂÈ˜ 263 (49,6) 163 (30,8) 104 (19,6)EÊ·ÚÌÔÁ‹ ÊıÔÚ›Ô˘ 215 (40,7) 125 (23,6) 189 (35,7)EÍ·ÁˆÁ¤˜ ‰ÔÓÙÈÒÓ 199 (37,6) 206 (39,0) 124 (23,4)¶ÚÔÏËÙÈÎ¤˜ Î·Ï‡„ÂÈ˜ 141 (26.6) 134 (25,3) 255 (48,1)ÔÒÓ Î·È Û¯ÈÛÌÒÓ¶ÂÚÈÔ‰ÔÓÙÈÎ‹ ıÂÚ·Â›· 109 (20,6) 159 (30,0) 262 (49,4)EÓ‰Ô‰ÔÓÙÈÎ‹ ıÂÚ·Â›· 59 (11,2) 193 (36,6) 276 (52,2)OÚıÔ‰ÔÓÙÈÎ‹ ıÂÚ·Â›· 7 (1,3) 36 (6,8) 487 (91,9)


ÓÙ·Ó Û¿ÓÈ·. OÈ ÚÔÛ¿ıÂÈÂ˜ÁÈ· ÙË ‚ÂÏÙ›ˆÛË ÙË˜ Î·Ù¿ÛÙ·-ÛË˜ ı· Ú¤ÂÈ Ó· ÂÛÙÈ·ÛÙÔ‡ÓÛÙËÓ ÂÎ·›‰Â˘ÛË ÙˆÓ Ô‰ÔÓÙÈ¿-ÙÚˆÓ Û¯ÂÙÈÎ¿ ÌÂ ÙËÓ Ô‰ÔÓÙÈ·-ÙÚÈÎ‹ ÊÚÔÓÙ›‰· ÂÈ‰ÈÎÒÓ ·ÛıÂ-ÓÒÓ ÙfiÛÔ Î·Ù¿ ÙË ‰È¿ÚÎÂÈ· ÙˆÓÚÔ- Î·È ÌÂÙ·-Ù˘¯È·ÎÒÓ ÛÔ˘-‰ÒÓ ÙÔ˘˜ fiÛÔ Î·È ÛÙË ‰È·-‚›Ô˘ÂÎ·›‰Â˘ÛË ÙÔ˘˜. B¤‚·È·, fiˆ˜Ï¤ÁÂÈ ¯·Ú·ÎÙËÚÈÛÙÈÎ¿ Ô McTique “...Ë ÂÎ·›‰Â˘ÛË, ·fi Ìfi-ÓË ÙË˜, ‰ÂÓ ÂÁÁ˘¿Ù·È fiÙÈ Ô Ô‰Ô-ÓÙ›·ÙÚÔ˜ ı· ıÂÚ·Â‡ÂÈ ·˘ÙÔ‡˜ÙÔ˘˜ ·ÛıÂÓÂ›˜ ÛÙÔ È·ÙÚÂ›Ô ÙÔ˘”22.

™XE¢IA™MO™O¢ONTIATPEIOY Afi Ù· ·Ú·¿Óˆ Û˘ÌÂÚ·›-ÓÔ˘ÌÂ fiÙÈ Î·Ù¿ ÙÔ Û¯Â‰È·ÛÌfiÂÓfi˜ Û‡Á¯ÚÔÓÔ˘ Ô‰ÔÓÙÈ·ÙÚÂ›Ô˘Ô˘ ·Ú¤¯ÂÈ ıÂÚ·Â›· ÛÂ AMÂAı· Ú¤ÂÈ Ó· Ï·Ì‚¿ÓÂÙ·È ÛÔ-‚·Ú¿ ̆ fi„Ë Ë ‰ÈÂ˘ÎfiÏ˘ÓÛË ÙË˜ÌÂÙ·Î›ÓËÛË˜ Î·È ÚfiÛ‚·ÛË˜ÙˆÓ ÂÌÔ‰È˙fiÌÂÓˆÓ ·ÙfiÌˆÓ.™ÙËÓ Î·ÙËÁÔÚ›· ·˘Ù‹ Û˘ÁÎ·Ù·-Ï¤ÁÔÓÙ·È ¿ÙÔÌ· ÌÂ ÂÈ‰ÈÎ¤˜ ·Ó¿-ÁÎÂ˜, ¿ÙÔÌ· ÙÚ›ÙË˜ ËÏÈÎ›·˜, ÔÈ¤ÁÎ˘Â˜ Á˘Ó·›ÎÂ˜, Ù· ¿ÙÔÌ· ÌÂ·Û˘Ó‹ıÂÈ˜ ÛˆÌ·ÙÈÎ¤˜ ‰È·ÛÙ¿-ÛÂÈ˜ (fiˆ˜ ÔÈ ˘¤Ú‚·ÚÔÈ) Î·È,Ù¤ÏÔ˜, fiÛÔÈ ¯ÚËÛÈÌÔÔÈÔ‡Ó ‹Ô‰ËÁÔ‡Ó ÔÔÈÔ˘‰‹ÔÙÂ Ù‡Ô˘·Ì·Í›‰ÈÔ23.™ÙËÓ EÏÏ¿‰· ÙÔ Y¶EXø¢E ‰Ë-ÌÈÔ‡ÚÁËÛÂ ÂÈ‰ÈÎfi ÙÌ‹Ì· ÁÈ· ÙËÌÂÏ¤ÙË ÙˆÓ ÚÔ‰È·ÁÚ·ÊÒÓ ÙˆÓ¯ÒÚˆÓ fiÔ˘ ÎÈÓÔ‡ÓÙ·È Î·ÈAMÂA. O ÊÔÚ¤·˜ ·˘Ùfi˜ ¤¯ÂÈÚÔ‚Â› ÛÂ NÔÌÔıÂÙÈÎ¤˜ Ú˘ıÌ›-ÛÂÈ˜ ‹‰Ë ·fi ÙÔ 1989 ÌÂ ÙËÓÌÔÚÊ‹ ÚÔ‰È·ÁÚ·ÊÒÓ ÁÈ· ÙËÓ·˘ÙfiÓÔÌË ‰È·Î›ÓËÛË Î·È ‰ÈÂ˘-ÎfiÏ˘ÓÛË ·ÙfiÌˆÓ ÌÂ ÂÈ‰ÈÎ¤˜ ·Ó¿-ÁÎÂ˜ ÛÂ ÎÔÈÓfi¯ÚËÛÙÔ˘˜ Î·È È‰Èˆ-ÙÈÎÔ‡˜ ¯ÒÚÔ˘˜.OÈ ÂÍˆÙÂÚÈÎÔ› ¯ÒÚÔÈ ÙÔ˘ È·ÙÚÂ›-Ô˘ Ô˘ ÂËÚÂ¿˙Ô˘Ó ÙËÓ Úfi-Û‚·ÛË ÙˆÓ AMÂA fiˆ˜ ÔÈ ¯Ò-ÚÔÈ ÛÙ¿ıÌÂ˘ÛË˜, ÔÈ ‰ÚfiÌÔÈ, Ù·Â˙Ô‰ÚfiÌÈ·, Î·È ÔÈ ÛÎ¿ÏÂ˜, Ú¤-ÂÈ Ó· ·Ú¤¯Ô˘Ó ·ÛÊ¿ÏÂÈ· Ì¤-Ûˆ ÙÔ˘ Û¯Â‰È·ÛÌÔ‡, ÙˆÓ ̄ ÚËÛÈ-

68


¶›Ó·Î·˜ 2

™YXNOTHTA BA£MOY ¢Y™KO§IA™ ™THN ¶APOXH ¢IAºOPøN EI¢øN O¢ONTIATPIKH™ £EPA¶EIA™ ™TA AMÂA

B·ıÌfi˜ ‰˘ÛÎÔÏ›·˜E›‰Ô˜ AÚÈıÌfi˜ (%)ıÂÚ·Â›·˜ Y„ËÏfi˜ M¤ÙÚÈÔ˜ X·ÌËÏfi˜

(ÎÏ›Ì·Î·: (ÎÏ›Ì·Î·: (ÎÏ›Ì·Î·: 6,8-10,0) 3,4-6,7) 0,0-3,3)

OÚıÔ‰ÔÓÙÈÎ‹ 301 (78,4) 67 (17,4) 16 (4,2)ıÂÚ·Â›·¶ÚÔÛıÂÙÈÎ¤˜ 294 (62,9) 153 (32,8) 20 (4,3)·ÔÎ·Ù·ÛÙ¿ÛÂÈ˜O‰ÔÓÙÈÎfi 210 (46,0) 210 (46,0) 37 (8,1)TÚ·‡Ì·¶ÂÚÈÔ‰ÔÓÙÈÎ‹ 162 (36,5) 232 (52,2) 50 (11,30ıÂÚ·Â›·EÍ·ÁˆÁ¤˜ 158 (32,6) 271 (56,0) 55 (11,4)‰ÔÓÙÈÒÓEÌÊÚ¿ÍÂÈ˜ 149 (30,7) (279) 57,5 57 (11,8)¶ÚfiÏË„Ë 97 (20,9) 206 (44,4) 161 (34,7)

EÈÎ. 1: ¢È·ÌfiÚÊˆÛË ÂÍˆÙÂÚÈÎÒÓ ¯ÒÚˆÓ (Y¶EXø¢E, 2011,http://www.minenv.gr/1/16/162/16203/g1620300.html)


ÌÔÔÈÔ‡ÌÂÓˆÓ ̆ ÏÈÎÒÓ Î·È ÙÔ˘ ÙÚfiÔ˘ Î·Ù·ÛÎÂ˘‹˜ ÙÔ˘˜24.™Â ÂÚ›ÙˆÛË Ô˘ Ë Â›ÛÔ‰Ô˜ ÙÔ˘ ÎÙÈÚ›Ô˘ Â›Ó·È ·ÓÈÛfiÂ‰ËÌÂ ÙÔÓ ÂÚÈ‚¿ÏÏÔÓÙ· ¯ÒÚÔ, Â›Ó·È ··Ú·›ÙËÙË Ë Û‡Ó‰ÂÛËÌÂÙ·Í‡ ÙÔ˘˜ ÌÂ ÙËÓ ‡·ÚÍË ÎÂÎÏÈÌ¤ÓˆÓ ÂÈ¤‰ˆÓ (Ú¿-ÌÂ˜) (ÂÈÎ. 1). TÔ ˘ÏÈÎfi Î·Ù·ÛÎÂ˘‹˜ ÙˆÓ ÎÂÎÏÈÌ¤ÓˆÓ ·˘-ÙÒÓ ÂÈ¤‰ˆÓ Ú¤ÂÈ ··Ú·›ÙËÙ· Ó· Â›Ó·È ·ÓÙÈÔÏÈÛıËÙÈ-Îfi, Ë ‰Â ÎÏ›ÛË ÙÔ˘˜ Ó· ÌËÓ ÍÂÂÚÓ¿ ÙÔ 10%. TÔ Ì‹ÎÔ˜ ÙË˜Ú¿Ì·˜ ‰ÂÓ Ú¤ÂÈ Ó· ÍÂÂÚÓ¿ Ù· 10 Ì¤ÙÚ·. H fiÚÙ· ÂÈ-Ûfi‰Ô˘ Ó· ¤¯ÂÈ Â‡ÚÔ˜ ÙÔ˘Ï¿¯ÈÛÙÔÓ 82 ÂÎ., ÌÂ ¯ÂÈÚÔÏ·‚¤˜ÛÂ ÚÔÛÈÙ¿ ÛËÌÂ›·, ÂÈ‰ÈÎ¿ Û‹Ì·Ù· ·Ó·ÁÓÒÚÈÛË˜ Î·È ·Ó¿-ÁÏ˘Ê· ÁÚ¿ÌÌ·Ù· ÁÈ· Ù· ¿ÙÔÌ· ÌÂ ÚÔ‚Ï‹Ì·Ù· fiÚ·ÛË˜Î·ıÒ˜ Î·È Ù· Ë¯ËÙÈÎ¿ Û‹Ì·Ù· ÁÈ· ÂÎÂ›ÓÔ˘˜ Ô˘ ¤¯Ô˘Ó ÚÔ-‚Ï‹Ì·Ù· ·ÎÔ‹˜24-25. OÈ ·ÓÂÏÎ˘ÛÙ‹ÚÂ˜ Ú¤ÂÈ Ó· ¤¯Ô˘Ó ‰¿-

Â‰Ô ÌÂ ·ÓÙÈÔÏÈÛıËÙÈÎfi ˘ÏÈÎfi Î·È ‰È·ÛÙ¿-ÛÂÈ˜ Ô˘ Ó· ÂÈÙÚ¤Ô˘Ó ÙÔ˘˜ ÂÏÈÁÌÔ‡˜ ÙˆÓ·Ì·ÍÈ‰›ˆÓ. OÈ ‰È·ÎfiÙÂ˜ ÙÔ˘˜ Ú¤ÂÈ Ó· ÙÔ-ÔıÂÙÔ‡ÓÙ·È Î·Ù·ÎfiÚ˘Ê·, ÌÂ ·Ó¿ÁÏ˘Ê·„ËÊ›· ÂÓÒ ÔÈ ÊˆÙÂÈÓÔ› ‰È·ÎfiÙÂ˜ ·Ê‹˜, Ó·‚Ú›ÛÎÔÓÙ·È ÛÂ ¯·ÌËÏfi ÛËÌÂ›Ô. O ¯ÒÚÔ˜ ·Ó·ÌÔÓ‹˜ Ú¤ÂÈ Ó· ÚÔÛÊ¤ÚÂÈÙË ‰˘Ó·ÙfiÙËÙ· ÂÏÂ‡ıÂÚË˜ Î˘ÎÏÔÊÔÚ›·˜ÙˆÓ ·ÙfiÌˆÓ ÌÂ ÂÈ‰ÈÎ¤˜ ·Ó¿ÁÎÂ˜ ¯ˆÚ›˜ ¯·-ÏÈ¿, ÌÂ ·ÓÙÈÔÏÈÛıËÙÈÎfi ‰¿Â‰Ô. OÈ ‰È·Îfi-ÙÂ˜ Ó· ‚Ú›ÛÎÔÓÙ·È ÛÂ ¯·ÌËÏfi ‡„Ô˜ ÂÓÒË ÙËÏÂÊˆÓÈÎ‹ Û˘ÛÎÂ˘‹ ‰ÂÓ Ú¤ÂÈ Ó· ‚Ú›-ÛÎÂÙ·È ¯·ÌËÏfiÙÂÚ· ·fi ‡„Ô˜ 90 ÂÎ.O ̄ ÒÚÔ˜ ÙÔ˘ Ô‰ÔÓÙÈ·ÙÚÂ›Ô˘ Ú¤ÂÈ Ó· ¤¯ÂÈÏÂÈÙÔ˘ÚÁÈÎfi ÂÚÈ‚¿ÏÏÔÓ ÌÂ Â·ÚÎ¤˜ Â‡ÚÔ˜ÂÈÛfi‰Ô˘ (fiÚÙ· ÙÔ˘Ï¿¯ÈÛÙÔÓ 80 ÂÎ.) Î·È ÌÂÂÏÂ‡ıÂÚÔ ¯ÒÚÔ Á‡Úˆ ·fi ÙËÓ Ô‰ÔÓÙÈ·-ÙÚÈÎ‹ ¤‰Ú· ‰ÈÂ˘ÎÔÏ‡ÓÔÓÙ·˜ ÙË ÌÂÙ·Î›ÓË-ÛË ·ÛıÂÓÔ‡˜ ÌÂ ·Ì·Í›‰ÈÔ Î·È ÙÔ˘ ÚÔÛˆ-ÈÎÔ‡ ÙÔ˘ È·ÙÚÂ›Ô˘. H Ô‰ÔÓÙÈ·ÙÚÈÎ‹ ¤‰Ú·ı· Ú¤ÂÈ Ó· Â›Ó·È Â˘¤ÏÈÎÙË, Ó· ÂÚÈÛÙÚ¤-ÊÂÙ·È Î·È Ó· ÚÔÛ·ÚÌfi˙ÂÙ·È ÛÙËÓ Î·Ù¿Ï-ÏËÏË ı¤ÛË Î·ıÒ˜ Î·È Ó· ¤¯ÂÈ ÙÚÔ¯‹Ï·Ù·ÌË¯·ÓÈÎ¿ Ì¤ÚË24-25. OÈ ¯ÒÚÔÈ ˘ÁÈÂÈÓ‹˜ ÙÔ˘ È·ÙÚÂ›Ô˘ ÌÂ ÔÚÈÛÌ¤-ÓÂ˜ ÙÚÔÔÔÈ‹ÛÂÈ˜ ÌÔÚÔ‡Ó Ó· Á›ÓÔ˘Ó ÏÂÈ-ÙÔ˘ÚÁÈÎÔ› ÁÈ· ¤Ó· ·ÛıÂÓ‹ ÌÂ ÂÈ‰ÈÎ¤˜ ·Ó¿-ÁÎÂ˜. K¿ıÂ ¯ÒÚÔ˜ ˘ÁÈÂÈÓ‹˜ Ú¤ÂÈ Ó· ÂÈ-ÙÚ¤ÂÈ ÙËÓ ‰È¤ÏÂ˘ÛË Î·È ·ÚfiÛÎÔÙË Î›ÓË-ÛË Î·È ÂÚÈÛÙÚÔÊ‹ ·Ó·ËÚÈÎÔ‡ ·Ì·ÍÈ‰›Ô˘.TÔ ÂÏ¿¯ÈÛÙÔ Â‡ÚÔ˜ ÙË˜ fiÚÙ·˜ ÂÈÛfi‰Ô˘ Â›-Ó·È 80 ÂÎ. H ÌÂÙ·ÊÔÚ¿ ÙˆÓ ·ÛıÂÓÒÓ Ô˘ ¯ÚËÛÈÌÔ-ÔÈÔ‡Ó ·Ó·ËÚÈÎ¿ ·Ì·Í›‰È· ÛÙËÓ Ô‰ÔÓÙÈ·-ÙÚÈÎ‹ ¤‰Ú· ¯ÚÂÈ¿˙ÂÙ·È È‰È·›ÙÂÚË ÚÔÛÔ¯‹Î·È ··ÈÙÂ› ÁÓÒÛÂÈ˜, ‰ÂÍÈÔÙÂ¯Ó›· Î·È ÂÌÂÈ-Ú›· ·fi ÙÔÓ È·ÙÚfi Î·È ÙÔ ‚ÔËıËÙÈÎfi ÚÔ-ÛˆÈÎfi ÙÔ˘ È·ÙÚÂ›Ô˘. O ÙÚfiÔ˜ ÂÈÏÔÁ‹˜ÂÍ·ÚÙ¿Ù·È ·fi ÙË Ì˘˚Î‹ ‰‡Ó·ÌË Î·È ÙÔ Û˘-ÓÙÔÓÈÛÌfi ÎÈÓ‹ÛÂˆÓ ÙÔ˘ ·ÛıÂÓÔ‡˜, ÙËÓ ÈÎ·-ÓfiÙËÙ· ÙÔ˘ È·ÙÚÔ‡ Î·È ÙÔ˘ ‚ÔËıËÙÈÎÔ‡ ÚÔ-ÛˆÈÎÔ‡ ÙÔ˘ È·ÙÚÂ›Ô˘ Î·È ÙÔÓ ‰È·ı¤ÛÈÌÔ¯ÒÚÔ Á‡Úˆ ·fi ÙËÓ Ô‰ÔÓÙÈ·ÙÚÈÎ‹ ¤‰Ú·. O

·ÛıÂÓ‹˜ ÌÔÚÂ› Ó· ÌÂÙ·Ê¤ÚÂÙ·È ·fi ÙÔ ·Ó·ËÚÈÎfi ·Ì·-Í›‰ÈÔ ÛÙËÓ Ô‰ÔÓÙÈ·ÙÚÈÎ‹ ¤‰Ú· ÌÂ ÙËÓ ‚Ô‹ıÂÈ· ÂÓfi˜ ÂÈ-ÎÏÈÓÔ‡˜ ÂÈ¤‰Ô˘, ÂÓfi˜ ‹ Î·È ‰‡Ô ·ÙfiÌˆÓ25.

EI¢IKO™ E•O¶§I™MO™ IATPEIOYH ·ÚÔ¯‹ Ô‰ÔÓÙÈ·ÙÚÈÎÒÓ ̆ ËÚÂÛÈÒÓ ÛÙÔ˘˜ ÂÈ‰ÈÎÔ‡˜ ·ÛıÂ-ÓÂ›˜ Â›Ó·È ·‰‡Ó·ÙË ¯ˆÚ›˜ ÙÔÓ ÂÈ‰ÈÎfi ÂÍÔÏÈÛÌfi Ô˘ ÂÍ·-ÛÊ·Ï›˙ÂÈ ÙËÓ Â˘ÎÔÏfiÙÂÚË Î·È ·ÛÊ·Ï¤ÛÙÂÚË Ô‰ÔÓÙÈ·ÙÚÈ-Î‹ ·ÓÙÈÌÂÙÒÈÛ‹ ÙÔ˘˜. T· Ì¤Û· Ô˘ ¯ÚËÛÈÌÔÔÈÔ‡ÓÙ·È,ÛÙÔ¯Â‡Ô˘Ó ÛÙËÓ: ·) ·ÎÈÓËÙÔÔ›ËÛË ÙÔ˘ ·ÛıÂÓÔ‡˜ fiÙ·Ó,ÁÈ· ‰È¿ÊÔÚÔ˘˜ ÏfiÁÔ˘˜, ·˘Ùfi˜ ‰ÂÓ ÌÔÚÂ› Ó· ·Ú·ÌÂ›ÓÂÈ·Î›ÓËÙÔ˜ ÛÙËÓ Ô‰ÔÓÙÈ·ÙÚÈÎ‹ ¤‰Ú·, ‚) ‰È¿ÓÔÈÍË ÙÔ˘ ÛÙfi-

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¶›Ó·Î·˜ 3

™YXNOTHTA ™TA™EøN KAI A¶OæEøN TøN O¢ONTIATPøN A¶ENANTI ™THN O¢ONTIATPIKH £EPA¶EIA TøN AMÂA

™Ù¿ÛÂÈ˜ ™˘ÌÊˆÓÒ ¢È·ÊˆÓÒ ¢ÂÓ ¤¯ˆ

Î·È ·fi„ÂÈ˜ (%) (%) ¿Ô„Ë(%)

H Ô‰ÔÓÙÈ·ÙÚÈÎ‹ 93,3 5,8 1,0ıÂÚ·Â›· Â›Ó·È¯ÚÔÓÔ‚fiÚ·

H ·ÚÔ¯‹ 91,7 6,5 1,7ıÂÚ·Â›·˜ Â›Ó·È‰‡ÛÎÔÏË

H ıÂÚ·Â›· ·˘ÙÒÓ 71,5 18,7 9,8ÙˆÓ ·ÙfiÌˆÓ ÚÔÛÊ¤ÚÂÈ ËıÈÎ‹·ÓÙ·ÌÔÈ‚‹

O Ô‰ÔÓÙ›·ÙÚÔ˜ 32,9 55,0 12,1Ú¤ÂÈ Ó· ‰È·ÙËÚÂ› ÙÔ ‰ÈÎ·›ˆÌ· Ó· ·ÚÓËıÂ› ÙË ıÂÚ·Â›· AMÂA

O Ô‰ÔÓÙ›·ÙÚÔ˜ 29,2 59,5 11,3Ú¤ÂÈ Ó· ·ÌÂ›‚ÂÙ·È ÂÚÈÛÛfiÙÂÚÔÈ ÁÈ· ÙË ıÂÚ·Â›· ÙˆÓ AMÂA Û˘ÁÎÚÈÙÈÎ¿ ·fi ¿ÏÏÔ˘˜ ·ÛıÂÓÂ›˜

OÈ ·ÛıÂÓÂ›˜ ·˘ÙÔ› ·Ó·ÛÙ·ÙÒÓÔ˘Ó 15,7 65,6 18,6¿ÏÏÔ˘˜ ·ÛıÂÓÂ›˜ ÛÙËÓ ·›ıÔ˘Û··Ó·ÌÔÓ‹˜

T· AMÂA ‰ÂÓ Â›Ó·È 9,2 77,2 13,6Û˘ÓÂÂ›˜ ÛÙ· Ú·ÓÙÂ‚Ô‡ ÙÔ˘˜



Ì·ÙÔ˜ ÙÔ˘, Á) ÚÔÛÙ·Û›· ÙÔ˘ ·ÛıÂÓÔ‡˜ Î·È ÙÔ˘ È·ÙÚÔ‡. MÂÚÈÎ¿ ·fi Ù· Ì¤Û· ·˘Ù¿ Ô˘ ̄ ÚËÛÈÌÔÔÈÔ‡ÓÙ·È ÈÔ Û˘-¯Ó¿ Â›Ó·È: T· Ì¤Û· ·ÎÈÓËÙÔÔ›ËÛË˜ ÙÔ˘ ·ÛıÂÓÔ‡˜ ÛÙËÓÔ‰ÔÓÙÈ·ÙÚÈÎ‹ ¤‰Ú· fiÙ·Ó Ô ·ÛıÂÓ‹˜ ‰ÂÓ Â›Ó·È Û˘ÓÂÚÁ¿ÛÈ-ÌÔ˜ ‹ ·Ó ÏfiÁˆ ÂÈ‰ÈÎÒÓ ÓÂ˘ÚÔÏÔÁÈÎÒÓ ‰È·Ù·Ú·¯ÒÓ ÂÌ-Ê·Ó›˙ÂÈ Û·ÛÙÈÎ¤˜ ‹ ·ıÂÙˆÛÈÎ¤˜ ÎÈÓ‹ÛÂÈ˜. ŒÓ·˜ ·fi ÙÔ˘˜ÙÚfiÔ˘˜ ÌÂ ÙÔ˘˜ ÔÔ›Ô˘˜ ÂÈÙ˘Á¯¿ÓÂÙ·È Ë ·ÎÈÓËÙÔÔ›Ë-ÛË ÙÔ˘ ·ÛıÂÓ‹ ÌÂ ·ÛÊ·Ï¤˜ ÙÚfiÔ Â›Ó·È Ë ·È‰È·ÙÚÈÎ‹Ê·ÛÎÈ¿23 (ÂÈÎ. 2).

T· Ì¤Û· ÛÙ‹ÚÈÍË˜ ÙÔ˘ ÛÒÌ·ÙÔ˜ ¯ÚËÛÈÌÔÔÈÔ‡ÓÙ·È ÁÈ·¿ÙÔÌ· ÌÂ Ì˘Ô-ÛÎÂÏÂÙÈÎ¤˜ ‹/Î·È ÓÂ˘ÚÔ-Ì˘Ô-ÛÎÂÏÂÙÈÎ¤˜ ‰È·-Ù·Ú·¯¤˜ fiˆ˜ ÚÂ˘Ì·ÙÔÂÈ‰‹ ·ÚıÚ›ÙÈ‰·, ÂÁÎÂÊ·ÏÈÎ‹ ·-Ú¿Ï˘ÛË Î·È Ì˘˚Î‹ ‰˘ÛÙÚÔÊ›· Î·È ¯ÚËÛÈÌÂ‡Ô˘Ó ÁÈ· ÙËÓÂÍ·ÛÊ¿ÏÈÛË ·Ó··˘ÙÈÎfiÙÂÚË˜ ı¤ÛË˜ ÙÔ˘ ·ÛıÂÓ‹ ÛÙËÓÔ‰ÔÓÙÈ·ÙÚÈÎ‹ ¤‰Ú·. T· Ì¤Û· ·˘Ù¿ Â›Ó·È Ì·ÍÈÏ¿ÚÈ·, ÛÙÚÒ-Ì·Ù· ·fi ·ÊÚÔÏ¤Í ‹ ÂÈ‰ÈÎ¿ ÊÔ˘ÛÎˆÙ¿ Ì·ÍÈÏ¿ÚÈ·(beanbags). ¶ÚÈÓ ·fi ÙË ̄ Ú‹ÛË ÙÔ˘˜ Ú¤ÂÈ Ó· Á›ÓÂÈ ÚÔ-ÛÂÎÙÈÎ‹ ÂÍ¤Ù·ÛË ÙÔ˘ ·ÛıÂÓ‹ Î·È ·ÍÈÔÏfiÁËÛË ÙÔ˘ ÚÔ-‚Ï‹Ì·Ùfi˜ ÙÔ˘ ÒÛÙÂ Ó· ÂÈÏÂÁÂ› ÙÔ Î·Ù·ÏÏËÏfiÙÂÚÔ Ì¤ÛÔÛÙ‹ÚÈÍË˜ ÙÔ˘ ÛÒÌ·Ùfi˜ ÙÔ˘24. ™Ù· Ì¤Û· ‰È¿ÓÔÈÍË˜ ÙÔ˘ÛÙfiÌ·ÙÔ˜ Û˘ÁÎ·Ù·Ï¤ÁÔÓÙ·È ÔÈ ÛÙÔÌ·ÙÔ‰È·ÛÙÔÏÂ›˜ (ÂÈÎ.3), Ô˘ ¯ÚËÛÈÌÔÔÈÔ‡ÓÙ·È ÛÂ ÂÚÈÙÒÛÂÈ˜ ·ÛıÂÓÒÓ Ô˘

‰ÂÓ ÌÔÚÔ‡Ó ‹ ‰ÂÓ ı¤ÏÔ˘Ó Ó· ·ÓÔ›ÍÔ˘Ó ÙÔ ÛÙfiÌ· ÙÔ˘˜.H ̄ Ú‹ÛË ÙÔ˘˜ Á›ÓÂÙ·È Â˘Ú‡Ù·Ù· ÛÂ ·ÛıÂÓÂ›˜ ÌÂ Ì˘˚Î‹ ‰˘-ÛÙÚÔÊ›·, ÛÎÏ‹Ú˘ÓÛË Î·Ù¿ Ï¿Î·˜, Ì˘·Ûı¤ÓÂÈ· Gravis,ÓfiÛÔ Parkinson, ÂÁÎÂÊ·ÏÈÎ‹ ·Ú¿Ï˘ÛË Î·ıÒ˜ Î·È ¿ÏÏÂ˜·ÚfiÌÔÈÂ˜ ÓÂ˘ÚÔÏÔÁÈÎ¤˜ ·ı‹ÛÂÈ˜. K·Ù¿ ÙË ¯Ú‹ÛË ÙÔ˘ ÛÙÔÌ·ÙÔ‰È·ÛÙÔÏ¤· ¯ÚÂÈ¿˙ÂÙ·È ÚÔ-ÛÔ¯‹ ÁÈ·Ù› ÌÔÚÂ› Ó· ÚÔÎÏËıÔ‡Ó ÚÔ‚Ï‹Ì·Ù· ·fi ÙËÓÎÚÔÙ·ÊÔÁÓ·ıÈÎ‹ ¿ÚıÚˆÛË Â¿Ó Á›ÓÂÈ ˘¤ÚÌÂÙÚË ‰È¿ÓÔÈ-ÍË ÙÔ˘ ÛÙfiÌ·ÙÔ˜, È‰È·›ÙÂÚ· ÛÂ ·ÛıÂÓÂ›˜ ÌÂ Ì˘˚Î¿ ÚÔ-‚Ï‹Ì·Ù·. °È· ÙÔ ÏfiÁÔ ·˘ÙfiÓ ¯ÚÂÈ¿˙ÂÙ·È Ë ¯·Ï¿ÚˆÛ‹ ÙÔ˘Î¿ıÂ 10 ÌÂ 15 ÏÂÙ¿ ÒÛÙÂ Ó· ·Ó··‡ÂÙ·È Ô ·ÛıÂÓ‹˜23,25.

™YM¶EPA™MATAH ‚È‚ÏÈÔÁÚ·Ê›· Û˘ÌÊˆÓÂ› Û¯Â‰fiÓ ÔÌfiÊˆÓ· ÛÙÔ ÁÂÁÔ-Ófi˜ fiÙÈ Ù· AMÂA ¤¯Ô˘Ó ÌÂÁ¿ÏË ·Ó¿ÁÎË ÁÈ· Ô‰ÔÓÙÈ·ÙÚÈÎ‹ıÂÚ·Â›·. T· ·ÔÙÂÏ¤ÛÌ·Ù· ÙË˜ ÌÂÏ¤ÙË˜ Ô˘ Ú·ÁÌ·-ÙÔÔÈ‹ıËÎÂ ÛÙË ¯ÒÚ· Ì·˜ ˘Ô‰ÂÈÎÓ‡Ô˘Ó fiÙÈ Ô ÁÂÓÈÎfi˜Ô‰ÔÓÙ›·ÙÚÔ˜ Â›Ó·È ·˘Ùfi˜ Ô˘ Î·ÏÂ›Ù·È Ó· ıÂÚ·Â‡ÛÂÈ Û˘-¯Ó¿ Ù· AMÂA. EÓÙÔ‡ÙÔÈ˜, ÂÓÒ Â›Ó·È Úfiı˘ÌÔ˜, ‰ÂÓ ¤¯ÂÈÂÎ·È‰Â˘ÙÂ› ÛÙË ıÂÚ·Â›· ÙˆÓ ·ÙfiÌˆÓ ·˘ÙÒÓ. ŒÙÛÈ ÏÔÈ-fiÓ, Â›Ó·È ··Ú·›ÙËÙË Ë ÂÎ·›‰Â˘ÛË ÙˆÓ Ô‰ÔÓÙÈ¿ÙÚˆÓÛÙËÓ Ô‰ÔÓÙÈ·ÙÚÈÎ‹ ıÂÚ·Â›· ÙˆÓ AMÂA ÙfiÛÔ Î·Ù¿ ÙË‰È¿ÚÎÂÈ· ÙˆÓ ÚÔ- Î·È ÌÂÙ·-Ù˘¯È·ÎÒÓ ÙÔ˘˜ ÛÔ˘‰ÒÓ fiÛÔÎ·È ÌÂ ÙË ‰È·-‚›Ô˘ Ì¿ıËÛË. K·ıÒ˜ Ô ·ÚÈıÌfi˜ ÙˆÓ AMÂA Ô˘ ·Ó·˙ËÙÔ‡Ó Ô‰ÔÓÙÈ·-

ÙÚÈÎ‹ ÊÚÔÓÙ›‰· ·˘Í¿ÓÂÙ·È Û˘ÓÂ¯Ò˜, Ë Û˘ÓÂÚÁ·Û›· ÙÔ˘ÁÂÓÈÎÔ‡ Ô‰ÔÓÙ›·ÙÚÔ˘ ÌÂ ÙÔÓ ·È‰Ô‰ÔÓÙ›·ÙÚÔ Î·È ÌÂ ¿Ï-ÏÂ˜ ÂÈ‰ÈÎfiÙËÙÂ˜ Â›Ó·È ··Ú·›ÙËÙË ÁÈ· ÙËÓ ·ÚÔ¯‹ ıÂÚ·-Â›·˜ ÛÙ· ¿ÙÔÌ· ·˘Ù¿. E›ÛË˜, ‰Â‰ÔÌ¤ÓÔ˘ fiÙÈ Ë Î·Î‹ÛÙÔÌ·ÙÈÎ‹ ̆ ÁÂ›· ·˘Í¿ÓÂÈ ÙÔÓ Î›Ó‰˘ÓÔ ÂÈÏÔÎÒÓ ÂÍ·ÈÙ›·˜ÙË˜ ‡·ÚÍË˜ ÌÔÏ‡ÓÛÂˆÓ Î·È ÌÂÈÒÓÂÈ ÙËÓ ÔÈfiÙËÙ· ˙ˆ‹˜ÙˆÓ AMÂA, Â›Ó·È ·Ó·ÁÎ·›· Ë Û˘ÓÔÏÈÎ‹ ·ÓÙÈÌÂÙÒÈÛË ÙˆÓÔ‰ÔÓÙÈ·ÙÚÈÎÒÓ ÙÔ˘˜ ·Ó·ÁÎÒÓ ÛÂ ÂÍÂÈ‰ÈÎÂ˘Ì¤Ó· Î¤ÓÙÚ·È‰ÈˆÙÈÎÔ‡ ‹/Î·È ‰ËÌfiÛÈÔ˘ ÊÔÚ¤· ·fi ÔÌ¿‰· ‰È·ÊfiÚˆÓÂ·ÁÁÂÏÌ·ÙÈÒÓ ˘ÁÂ›·˜.

SUMMARY

Provision of dental treatment to patients with physical or mental problem

Gizani S.


The study aims to a) present review findings about the oralhealth and the need for provision of dental treatment topersons with special needs (PSN), b) describe the findingsof a study on the knowledge, attitude and provision of oralhealth care by dentists, who attended the 26th Congressof the Hellenic Dental Association, c) present data aboutthe necessary modifications of a dental office for the accessand provision of treatment for PSN. These persons are classified based on the degree of self-reliance, and their physical, mental, psychological or

EÈÎ. 2: ¶·È‰È·ÙÚÈÎ‹ Ê·ÛÎÈ¿ (www.specializedcare.com, access 2011)

EÈÎ. 3: ™ÙÔÌ·ÙÔ‰È·ÛÙÔÏÂ›˜ ‰È·ÊÔÚÂÙÈÎÔ‡ ÌÂÁ¤ıÔ˘˜.

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functional problem. The literature almost unanimouslyagrees on the fact that PSN have great unmet needs fordental treatment. The findings of a study that was carriedout in our country indicate that it is the general dentist whomostly provides treatment to PSN. Although he is willing,he is not trained for this. Therefore the education of thedentists for the oral health care of PSN is necessary duringtheir under- and post-graduate studies as well as forcontinuing-education. The transportation and access of PSN to the dental officeis crucial and consequently leads to the fact that this shouldbe taken into consideration when a dental office is designed.The provision of dental care to PSN is not feasible withoutthe special equipment that ensures the easiest and safestmanagement of these patients. As the number of PSN whoseeks dental care is constantly increasing, the cooperationof the general dentist with the paediatric dentist and otherspecialties is necessary for the provision of oral health carefor these patients.

Key words: dentists’ attitudes; oral health; persons withspecial needs; education; provision of dental treatment;access

BIB§IO°PAºIA1. ™ÙÔÈ¯Â›· ·ÔÁÚ·Ê‹˜ AMÂA ÛÙËÓ E˘Úˆ·˚Î‹ ŒÓˆÛË, 2003,

http://www.realising-potential.org/stakeholder-factbox/disabled-people-worldwide/

2. ™ÙÔÈ¯Â›· ·ÔÁÚ·Ê‹˜ AMEA ÛÙËÓ EÏÏ¿‰·, EıÓÈÎ‹ ™Ù·ÙÈÛÙÈÎ‹YËÚÂÛ›· (E™Y),1991, http://www.disabled.gr/lib/?/p=11563

3. °ÎÈ˙¿ÓË ™, ¶··ÁÈ·ÓÓÔ‡ÏË § (·): “ÕÙÔÌ· ÌÂ ÂÈ‰ÈÎ¤˜ ·Ó¿-ÁÎÂ˜”. È. Î·ÙËÁÔÚ›Â˜, ÛÙÔÌ·ÙÈÎ‹ ˘ÁÂ›·, È‰È·ÈÙÂÚfiÙËÙÂ˜ Ô‰Ô-ÓÙÈ·ÙÚÈÎ‹˜ ÂÚ›ı·Ï„Ë˜. ™ËÌÂÈÒÛÂÈ˜ ¶·È‰Ô‰ÔÓÙÈ·ÙÚÈÎ‹˜ IIÁÈ· ÙÔ˘˜ ÊÔÈÙËÙ¤˜ 9Ô˘ ÂÍ·Ì‹ÓÔ˘. 2011, ÛÂÏ. 122-135.

4. American Academy of Pediatric Dentistry (AAPD): Guidelineon management of dental patients with special health careneeds, Reference Manual. Pediatr Dent 2008-2009; 30(7):107-111.

5. Vignehsa H, Soh G, Lo LG, Chellappah NK: Dental health ofdisabled children in Singapore. Aust Dent J 1991; 36(2):151-156.

6. Gizani S, Declerck D, Vinckier F, Martens L, Marks L, GoffinG: Oral health condition of 12-year-old handicapped chil-dren in Flanders (Belgium). Community Dent Oral Epidemiol1997; 25: 352-357.

7. Hennequin M, Moysan V, Jourdan D, Dorin M, Nicolas E:Inequalities in oral health for children with disabilities: A Frenchnational survey in special schools. Plos One 2008; 3: 1-10.

8. Lawton L: Providing oral health care for special patients.Tips for the general dentist. J Am Dent Assoc 2002; 133:

1666-1671.9. Glassman P, Miller C: Preventing dental disease for people

with special needs: the need for practical preventive proto-cols for use in community settings. Special Care Dent 2003;23: 165-167.

10. Shaw L, MacLaurin ET, Foster TD: Dental study of handi-capped children attending special schools in Birmingham,UK. Community Dent Oral Epidemiol 1986; 14: 24-7.

11. Nunn JH: The dental health of mentally and physicallyhandicapped children: a review of the literature. CommunityDent Health 1987; 4: 157-68.

12. Palin-Palokas T, Hausen H, Heinonen OP: Relativeimportance of caries risk factors in Finnish mentally retardedchildren. Community Dent Oral Epidemiol 1987; 15: 19-23.

13. Martens L, Marks L, Goffin G, Gizani S, Declerck D, VinckierF: Oral hygiene in 12 year old disabled children in Flanders,Belgium, related to manual dexterity. Community Dent OralEpidemiol 2000; 28: 73-80.

14. Oreland A, Heijbel J, Lagell S: Malocclusion in physicallyand/or mentally handicapped children. Swed Dent J 1987;11: 103-119.

15. Franklin DL, Luther F, Curzon MEJ: The prevalence ofmalocclusion in children with cerebal palsy. Eur J Orthod1996; 18: 637-643.

16. AlSarheed M, Bedi R, Hunt N: The views and attitudes ofparents of children with a sensory impairment towardsorthodontic care. Eur J Orthod 2004; 26: 87-91.

17. Bedi R, Champion J, Horn R: Attitudes of the dental team tothe provision of care for people with learning disabilities.Spec Care Dent 2001; 21(4): 147-52.

18. Crall JJ: Improving oral health and oral health care deliveryfor children. J Calif Dent Assoc 2011; 39(2): 90-100. Erratumin: J Calif Dent Assoc 2011; 39(3):138.

19. Gizani S, Papaioannou W, Papagiannoulis L: Oral healthfindings in a group of Greek schoolchildren with mild mentalimpairment. J Dis Oral Health 2006; 7(1): 3-9.

20. Kavvadia K. Gizani S, Mamali S, Nassika M: Oral healthstatus of teenagers and young adults with intellectualimpairment in Athens, Greece. J Dis and Oral Health 2008;9(2): 63-69.

21. Gizani S, Kandilorou H, Kavvadia K, Tzoutzas J: Oral healthcare provided by Greek dentists to persons with physicaland/or intellectual impairment. Spec Care Dent 2012; 32(3):83-89.

22. Mc Tigue DJ: Dental education and special-needs patients:challenges and opportunities. Pediatr Dent 2007; 29: 129-133.

23. °ÎÈ˙¿ÓË ™, ¶··ÁÈ·ÓÓÔ‡ÏË § (‚): “ÕÙÔÌ· ÌÂ ÂÈ‰ÈÎ¤˜ ·Ó¿-ÁÎÂ˜. ÈÈ. Û¯Â‰È·ÛÌfi˜ È·ÙÚÂ›Ô˘ ÁÈ· ÂÌÔ‰È˙fiÌÂÓ· ¿ÙÔÌ·”. ™Ë-ÌÂÈÒÛÂÈ˜ ¶·È‰Ô‰ÔÓÙÈ·ÙÚÈÎ‹˜ II ÁÈ· ÙÔ˘˜ ÊÔÈÙËÙ¤˜ 9Ô˘ ÂÍ·-Ì‹ÓÔ˘. 2011, ÛÂÏ. 136-151.

24. O‰ËÁ›Â˜ Û¯Â‰È·ÛÌÔ‡ ÁÈ· ÙËÓ ·˘ÙfiÓÔÌË ‰È·‚›ˆÛË AMEA.Y¶EXø¢E. °Ú·ÊÂ›Ô ÌÂÏÂÙÒÓ ÁÈ· ¿ÙÔÌ· ÌÂ ÂÈ‰ÈÎ¤˜ ·Ó¿ÁÎÂ˜.http://www.minenv.gr/1/16/162/16203/g1620300.html, 2011

25. BÈ¤ÚÚÔ˘ A-M, ¶··ÁÈ·ÓÓÔ‡ÏË §: ™¯Â‰È·ÛÌfi˜ Î·È ÂÍÔÏÈ-ÛÌfi˜ Ô‰ÔÓÙÈ·ÙÚÂ›Ô˘ ÁÈ· ÙËÓ ·ÓÙÈÌÂÙÒÈÛË ·ÙfiÌˆÓ ÌÂ ÂÈ‰È-Î¤˜ ·Ó¿ÁÎÂ˜. ¶·È‰Ô‰ÔÓÙ›· 1997; 11(1): 21-29.



¢ÈÂ‡ı˘ÓÛË ÁÈ· ÂÈÎÔÈÓˆÓ›·:™ˆÙËÚ›· °ÎÈ˙¿ÓËEÏ. BÂÓÈ˙¤ÏÔ˘ 19917123 N. ™Ì‡ÚÓË, Aı‹Ó·TËÏ: 210 9318813e-mail: [email protected]

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Afi 30 ™ÂÙÂÌ‚Ú›Ô˘ ¤ˆ˜ 2 OÎÙˆ‚Ú›Ô˘ 2011 ¤Ï·‚Â ̄ ÒÚ·ÛÙÔÓ ˙ÂÛÙfi ¯ÒÚÔ ÙÔ˘ ¶ÓÂ˘Ì·ÙÈÎÔ‡ K¤ÓÙÚÔ˘ ÙÔ˘ ¢‹ÌÔ˘AıËÓ·›ˆÓ, ÙÔ 4Ô ¶·ÓÂÏÏ‹ÓÈÔ ™˘Ó¤‰ÚÈÔ ÙË˜ EÏÏËÓÈÎ‹˜EÙ·ÈÚÂ›·˜ NÔÛÔÎÔÌÂÈ·Î‹˜ O‰ÔÓÙÈ·ÙÚÈÎ‹˜ (EENO) ÌÂÙ›ÙÏÔ «H O‰ÔÓÙÈ·ÙÚÈÎ‹ EÈ‰ÈÎ‹˜ ºÚÔÓÙ›‰·˜ ÛÙÔÓ 21Ô AÈÒ-Ó·». TÔ ™˘Ó¤‰ÚÈÔ Â›¯Â ÙÂıÂ› ˘fi ÙËÓ ·ÈÁ›‰· ÙÔ˘ YÔ˘ÚÁÂ›Ô˘YÁÂ›·˜ Î·È KÔÈÓˆÓÈÎ‹˜ AÏÏËÏÂÁÁ‡Ë˜, ÙË˜ O‰ÔÓÙÈ·ÙÚÈÎ‹˜™¯ÔÏ‹˜ ÙÔ˘ ¶·ÓÂÈÛÙËÌ›Ô˘ AıËÓÒÓ, ÙˆÓ O‰ÔÓÙÈ·ÙÚÈÎÒÓ™˘ÏÏfiÁˆÓ AÙÙÈÎ‹˜ Î·È ¶ÂÈÚ·ÈÒ˜ Î·È ‰ÈÂÍ‹¯ıË ÌÂ ÙËÓ ÙÈ-ÌËÙÈÎ‹ Û˘ÓÂÚÁ·Û›· ÙË˜ EÏÏËÓÈÎ‹˜ O‰ÔÓÙÈ·ÙÚÈÎ‹˜ OÌÔ-ÛÔÓ‰›·˜, ÊÔÚÂ›˜ ÔÈ ÔÔ›ÔÈ ‰È·¯ÚÔÓÈÎ¿ ÛÙËÚ›˙Ô˘Ó ÙÈ˜ ÂÎ-‰ËÏÒÛÂÈ˜ ÙË˜ EÙ·ÈÚÂ›·˜ Î·È ÙÔ˘˜ ÔÔ›Ô˘˜ Ë EENO Â˘¯·-ÚÈÛÙÂ› ıÂÚÌ¿.H ÂÈÛÙËÌÔÓÈÎ‹ ·˘Ù‹ ÂÎ‰‹ÏˆÛË Ú·ÁÌ·ÙÔÔÈ‹ıËÎÂ ÛÂÌÈ· ÂÚ›Ô‰Ô ÎÈÓËÙÈÎfiÙËÙ·˜ ÛÂ ‰ÈÂıÓ¤˜ ·ÏÏ¿ Î·È ÛÂ ÂÏÏË-ÓÈÎfi Â›Â‰Ô ÁÈ· Ù· ̇ ËÙ‹Ì·Ù· ÙË˜ EÈ‰ÈÎ‹˜ O‰ÔÓÙÈ·ÙÚÈÎ‹˜ºÚÔÓÙ›‰·˜. H ºÚÔÓÙ›‰· ÙÔ˘ EÈ‰ÈÎÔ‡ O‰ÔÓÙÈ·ÙÚÈÎÔ‡AÛıÂÓ‹ Ù›ıÂÙ·È Ï¤ÔÓ ÛÙÔ Â›ÎÂÓÙÚÔ ÙË˜ ÚÔÛÔ¯‹˜ ÙˆÓ™˘ÛÙËÌ¿ÙˆÓ YÁÂ›·˜ Î·È EÎ·›‰Â˘ÛË˜. TËÓ OÚÁ·ÓˆÙÈÎ‹ EÈÙÚÔ‹ ·ÔÙ¤ÏÂÛ·Ó ÔÈ Î.Î. ºÏÒÚ·ZÂÚ‚Ô‡-B¿Ï‚Ë ˆ˜ ¶ÚfiÂ‰ÚÔ˜, M¿ÚÈÔ˜ ºÚ·ÁÎ¿ÎË˜ ˆ˜™˘ÓÙÔÓÈÛÙ‹˜, £ÂÔÓ‡ÌÊË ZÔ˘ÚÈ‰¿ÎË Î·È ¶¤ÙÚÔ˜ £·ÓÔ‡-ÏË˜ ̂ ˜ AÓÙÈÚfiÂ‰ÚÔÈ, AÏÂÍ¿Ó‰Ú· AÓÙˆÓÈ¿‰Ô˘ ̂ ˜ °Ú·Ì-Ì·Ù¤·˜ Î·È YÂ‡ı˘ÓË °Ú·ÌÌ·ÙÂ›·˜, Iˆ¿ÓÓË˜ KÔ˘ÙÛÔ‡-ÎÔ˜ ˆ˜ T·Ì›·˜, ¢ÈÔÓ‡ÛÈÔ˜ AÓ‰ÚÂÛ¿ÎË˜, N›ÎÔ˜ K·Ï¿-ÓË˜, MÈ¯¿ÏË˜ K·ÙÛÔ˘Ú¿ÎË˜, ¢ËÌ‹ÙÚË˜ KÔ˘ÙÔ‡Ï·˜, ¶·-Ó·ÁÈÒÙ· M·Ú·ÁÎÔ‡, E˘·ÁÁÂÏ›· MÔÁÔÛÈ¿Ó, ™ˆÙ‹ÚË˜MfiÙÛÈÔ˜, AÓÙˆÓ›· ¶ÔÏ¿ÙÔ˘ Î·È AÈÎ·ÙÂÚ›ÓË TÚ›ÌË ˆ˜M¤ÏË. ™ÙËÓ EÈÛÙËÌÔÓÈÎ‹ ÙÔ˘ EÈÙÚÔ‹ Û˘ÌÌÂÙÂ›¯·Ó ÔÈ Î.Î.K·›ÙË K·Ú·ÁÈ¿ÓÓË, K·ıËÁ‹ÙÚÈ· Î·È ¶ÚfiÂ‰ÚÔ˜ ÙË˜ O‰Ô-ÓÙÈ·ÙÚÈÎ‹˜ ™¯ÔÏ‹˜ EK¶A, ˆ˜ ¶ÚfiÂ‰ÚÔ˜, Ô K·ıËÁËÙ‹˜°ÂÒÚÁÈÔ˜ BÔ˘ÁÈÔ˘ÎÏ¿ÎË˜, AÓ·Ï. ¶ÚfiÂ‰ÚÔ˜ ÙË˜ O‰Ô-ÓÙÈ·ÙÚÈÎ‹˜ ™¯ÔÏ‹˜ EK¶A Î·È Ô K·ıËÁËÙ‹˜ NÈÎfiÏ·Ô˜ ¶·-·‰ÔÁÂˆÚÁ¿ÎË˜, ¶ÚfiÂ‰ÚÔ˜ ÙË˜ EıÓÈÎ‹˜ EÈÙÚÔ‹˜™ÙÔÌ·ÙÈÎ‹˜ YÁÂ›·˜ ˆ˜ ™˘ÓÙÔÓÈÛÙ¤˜, Î·È ˆ˜ M¤ÏË ÔÈ K·-ıËÁËÙ¤˜ KˆÓÛÙ·ÓÙ›ÓÔ˜ AÏÂÍ·Ó‰Ú›‰Ë˜, KˆÓÛÙ·ÓÙ›ÓÔ˜AÓÙˆÓÈ¿‰Ë˜, O˘Ú·Ó›· NÈÎÔÏ¿ÙÔ˘-°·Ï›ÙË, AÏÂÍ¿Ó‰Ú·™ÎÏ·‚Ô‡ÓÔ˘ Î·È KˆÓÛÙ·ÓÙ›ÓÔ˜ TÛÈ¯Ï¿ÎË˜, Â›ÛË˜ ÔÈAÓ·Ï. K·ıËÁËÙ¤˜ HÚ·ÎÏ‹˜ K·ÚÎ·˙‹˜ Î·È Iˆ¿ÓÓË˜T˙Ô‡Ù˙·˜ Î·ıÒ˜ Î·È Ë E›Î. K·ıËÁ‹ÙÚÈ· AÓ·ÛÙ·Û›· KÔ-ÛÈÒÓË. K·Ù¿ ÙËÓ ÙÂÏÂÙ‹ ¤Ó·ÚÍË˜, Ï¤ÔÓ ÙË˜ ¶ÚÔ¤‰ÚÔ˘ ÙË˜EENO Î. ºÏÒÚ·˜ ZÂÚ‚Ô‡-B¿Ï‚Ë Ô˘ ÌÂÙ¤ÊÂÚÂ Î·È ÙÔÌ‹Ó˘Ì· ÙË˜ OÚÁ·ÓˆÙÈÎ‹˜ EÈÙÚÔ‹˜, ÚÔÛÊÒÓËÛ·Ó Ë¶ÚfiÂ‰ÚÔ˜ ÙË˜ O‰ÔÓÙÈ·ÙÚÈÎ‹˜ ™¯ÔÏ‹˜ ÙÔ˘ ¶·ÓÂÈÛÙËÌ›-Ô˘ AıËÓÒÓ Î. K·›ÙË K·Ú·ÁÈ¿ÓÓË Î·È Ô ¶ÚfiÂ‰ÚÔ˜ ÙÔ˘O‰ÔÓÙÈ·ÙÚÈÎÔ‡ ™˘ÏÏfiÁÔ˘ ¶ÂÈÚ·ÈÒ˜ Î. ¢ËÌ‹ÙÚË˜ M·˘Ú›-

‰Ë˜ ÂÓÒ ÙËÓ Î‹Ú˘ÍË ÙË˜ ¤Ó·ÚÍË˜ ÙˆÓ ÂÚÁ·ÛÈÒÓ ¤Î·ÓÂ Ô¶ÚfiÂ‰ÚÔ˜ ÙË˜ EÏÏËÓÈÎ‹˜ O‰ÔÓÙÈ·ÙÚÈÎ‹˜ OÌÔÛÔÓ‰›·˜Î. Aı·Ó¿ÛÈÔ˜ K·ÙÛ›ÎË˜.™ÙË Û˘Ó¤¯ÂÈ· Ë EENO ·¤ÙÈÛÂ ÊfiÚÔ ÙÈÌ‹˜ ÛÂ ¤Ó· Ï·-ÌÚfi ¿ÓıÚˆÔ Î·È ÂÈÛÙ‹ÌÔÓ·, ÙÔÓ EÏ‚ÂÙfi Ô‰ÔÓÙ›·ÙÚÔDr Julien Grivel, ÁÈ· ÙËÓ ÂıÂÏÔÓÙÈÎ‹ ÙÔ˘ ‰Ú¿ÛË Î·È ÙËÓÔÏ˘ÂÙ‹ ·ÚÔ¯‹ ÓÔÛÔÎÔÌÂÈ·ÎÒÓ Ô‰ÔÓÙÈ·ÙÚÈÎÒÓ ˘ËÚÂ-ÛÈÒÓ ÛÙÔ˘˜ ŒÏÏËÓÂ˜ ¯·ÓÛÂÓÈÎÔ‡˜. TÔ ‚ÈÔÁÚ·ÊÈÎfi Î·È ÙÔ¤ÚÁÔ ÙÔ˘ ·ÚÔ˘Û›·ÛÂ Ô °ÂÓ. °Ú·ÌÌ·Ù¤·˜ ÙË˜ EENO Î.M¿ÚÈÔ˜ ºÚ·ÁÎ¿ÎË˜, Ô ÔÔ›Ô˜ ‹Ù·Ó Î·È Ô ÂÌÓÂ˘ÛÙ‹˜ÙË˜ È‰¤·˜ ÙË˜ ÂÎ‰‹ÏˆÛË˜ ·˘Ù‹˜. K·ÙfiÈÓ, Ë ¶ÚfiÂ‰ÚÔ˜ÙË˜ EENO Î. ºÏÒÚ· ZÂÚ‚Ô‡, ÂÎÚÔÛˆÒÓÙ·˜ ÙÔ ¢ÈÔÈ-

4Ô ™˘Ó¤‰ÚÈÔ EÏÏËÓÈÎ‹˜ EÙ·ÈÚÂ›·˜ NÔÛÔÎÔÌÂÈ·Î‹˜ O‰ÔÓÙÈ·ÙÚÈÎ‹˜

ŒÓ· ‰È·ÊÔÚÂÙÈÎfi ™˘Ó¤‰ÚÈÔ

H ¶ÚfiÂ‰ÚÔ˜ ÙË˜ EENO Î. ºÏÒÚ· ZÂÚ‚Ô‡-B¿Ï‚Ë ÚÔÛÊˆÓÂ›,˘Ô‰¤¯ÂÙ·È ÙÔ˘˜ Â›ÛËÌÔ˘˜ ÚÔÛÎÂÎÏËÌ¤ÓÔ˘˜ Î·È ÙÔ˘˜ Û˘Ó¤-‰ÚÔ˘˜ Î·È ÌÂÙ·Ê¤ÚÂÈ ÙÔ Ì‹Ó˘Ì· ÙË˜ OÚÁ·ÓˆÙÈÎ‹˜ EÈÙÚÔ‹˜.

O Dr Julien Grivel ‰›‰ÂÈ ÙËÓ ÂÓ·ÚÎÙ‹ÚÈ· ÔÌÈÏ›· ÙÔ˘ ™˘ÓÂ‰Ú›Ô˘.


ÎËÙÈÎfi ™˘Ì‚Ô‡ÏÈÔ, ·Ó·Î‹Ú˘ÍÂ ÙÔÓ Dr Grivel E›ÙÈÌÔ ¶Úfi-Â‰ÚÔ ÙË˜ EÙ·ÈÚÂ›·˜ Î·È ÙÔ˘ Â¤‰ˆÛÂ ÙÈÌËÙÈÎ‹ Ï·Î¤Ù·Î·È ·Ó·ÌÓËÛÙÈÎfi ‰ÒÚÔ. TËÓ ÂÎ‰‹ÏˆÛË Ù›ÌËÛÂ ÌÂ ÙËÓ ·-ÚÔ˘Û›· ÙÔ˘ Î·È Ô ¶Ú¤Û‚Ë˜ ÙË˜ EÏ‚ÂÙ›·˜ ÛÙËÓ EÏÏ¿‰· Î.Lorenzo Amberg, Ô ÔÔ›Ô˜ ·Ú¤ÛÙË Û˘ÓÔ‰Â˘fiÌÂÓÔ˜ ·-fi ÙËÓ Û‡˙˘Áfi ÙÔ˘ Î·È ·Ë‡ı˘ÓÂ ¯·ÈÚÂÙÈÛÌfi ÛÙ· ÂÏÏËÓÈ-Î¿. ™ÙË Û˘Ó¤¯ÂÈ·, Ô Dr Grivel, ÛÂ Ú¤Ô˘Û· ÂÏÏËÓÈÎ‹ ÁÏÒÛ-Û· Î·È ÌÂ ÁÏ·Ê˘Úfi ‡ÊÔ˜ ¤Î·ÓÂ ÙËÓ ÂÓ·ÚÎÙ‹ÚÈ· ÔÌÈÏ›·ÙÔ˘ ™˘ÓÂ‰Ú›Ô˘ ÌÂ ı¤Ì· «O‰ÔÓÙÈ·ÙÚÈÎ‹ ÂÚ›ı·Ï„Ë ÛÂ¯·ÓÛÂÓÈÎÔ‡˜ ·ÛıÂÓÂ›˜. H ·›ı·ÓË Û˘Ó¿ÓÙËÛË ÂÓfi˜EÏ‚ÂÙÔ‡ Ô‰ÔÓÙ›·ÙÚÔ˘ ÌÂ ÙÔ˘˜ ¯·ÓÛÂÓÈÎÔ‡˜ ·ÛıÂÓÂ›˜ÛÙÔ NÔÛÔÎÔÌÂ›Ô §ÔÈÌˆ‰ÒÓ NfiÛˆÓ AÁ›· B·Ú‚¿Ú· ÛÙÔAÈÁ¿ÏÂˆ». TÔ ÂÚÈÂ¯fiÌÂÓÔ ÙË˜ ÔÌÈÏ›·˜ Î·È Ô ÙÚfiÔ˜ ·-ÚÔ˘Û›·ÛË˜ ¤Î·Ó·Ó Ê·ÓÂÚ¿ ÙÔÓ ·ÓıÚˆÈÛÌfi, ÙÔÓ ÊÈÏÂÏ-ÏËÓÈÛÌfi Î·È ÙÔ ÂÚ›ÛÛÂ˘Ì· ÙË˜ Î·Ú‰È¿˜ ÙÔ˘ ÔÌÈÏÔ‡ÓÙÔ˜.H Û˘ÁÎ›ÓËÛË Ô˘ ÙÔÓ ‰È·Î·ÙÂ›¯Â ‰È·¯‡ıËÎÂ ÛÂ fiÏÔ ÙÔ ·-ÎÚÔ·Ù‹ÚÈÔ Ô˘ ÌÂ ıÚËÛÎÂ˘ÙÈÎ‹ Â˘Ï¿‚ÂÈ· ·Ú·ÎÔÏÔ‡ıË-ÛÂ ÙËÓ ÔÌÈÏ›· ÙÔ˘. H fiÏË ÂÎ‰‹ÏˆÛË ·ÔÙ¤ÏÂÛÂ Ì›· ·ÏË-ÛÌfiÓËÙË ÂÌÂÈÚ›· ÁÈ· fiÏÔ˘˜ Î·È ¤‰ˆÛÂ Ì›· ‰È·ÊÔÚÂÙÈÎ‹‰È¿ÛÙ·ÛË ÛÙÔ ™˘Ó¤‰ÚÈÔ ·˘Ùfi. H ‚Ú·‰È¿ ¤ÎÏÂÈÛÂ ÌÂ ÙËÓ ·Ú¿ıÂÛË ‰ÂÍ›ˆÛË˜, Ë ÔÔ›·Í¤Ê˘ÁÂ Î·È ·˘Ù‹ ·fi Ù· Î·ıÈÂÚˆÌ¤Ó·, ·ÊÔ‡ Ë ‡·ÚÍËÛÙÔ ÌÔ˘Ê¤ Î·È ÌÈ·˜ ÎÚËÙÈÎ‹˜ ÁˆÓÈ¿˜ (ÌÂ ÙËÓ KÚ‹ÙË Û˘Ó-‰¤ÂÙ·È È‰È·›ÙÂÚ· Ô Dr Grivel) ÌÂ ÚÔ˚fiÓÙ· ÙË˜ ÎÚËÙÈÎ‹˜ÁË˜ ÌÂÙ·Í‡ ÙˆÓ ÔÔ›ˆÓ Î·È Ë Ú·Î‹, Û˘Ó¤‚·ÏÂ Î·È ·˘Ù‹ ÌÂ

ÙÔÓ ÙÚfiÔ ÙË˜ ÛÙËÓ ·Ó¿‰ÂÈÍË ÌÈ·˜ ‰È·ÊÔÚÂÙÈÎfiÙËÙ·˜.™ÙÔ ÂÈÛÙËÌÔÓÈÎfi ÚfiÁÚ·ÌÌ· ÂÚÈÂÏ‹ÊıËÛ·Ó ÙÂÏÈÎ¿ 5ÛÙÚÔÁÁ˘Ï¿ ÙÚ·¤˙È·, 19 ÂÈÛËÁ‹ÛÂÈ˜, ‰‡Ô ÂÈ‰ÈÎ¤˜ ‰È·Ï¤-ÍÂÈ˜, ¤Ó· ÛÂÌÈÓ¿ÚÈÔ Î·È 47 ÂÏÂ‡ıÂÚÂ˜ ·Ó·ÎÔÈÓÒÛÂÈ˜. TÔ™˘Ó¤‰ÚÈÔ Ù›ÌËÛ·Ó ÌÂ ÙËÓ ÂÓÂÚÁfi Û˘ÌÌÂÙÔ¯‹ ÙÔ˘˜ ‰È·-ÚÂ‹ Ì¤ÏË ÙÔ˘ ¢E¶ ÙˆÓ O‰ÔÓÙÈ·ÙÚÈÎÒÓ Ì·˜ ™¯ÔÏÒÓ fi-ÏˆÓ ÙˆÓ ‚·ıÌ›‰ˆÓ, ÌÂÙ·Í‡ ÙˆÓ ÔÔ›ˆÓ Ë ¶ÚfiÂ‰ÚÔ˜ ÙË˜O‰ÔÓÙÈ·ÙÚÈÎ‹˜ ™¯ÔÏ‹˜ EK¶A Î. K·›ÙË K·Ú·ÁÈ¿ÓÓË Î·-ıÒ˜ Î·È ÔÈ ‰‡Ô K·ıËÁËÙ¤˜ ÙË˜ NÔÛÔÎÔÌÂÈ·Î‹˜ O‰ÔÓÙÈ·-ÙÚÈÎ‹˜ Î.Î. KˆÓÛÙ·ÓÙ›ÓÔ˜ AÓÙˆÓÈ¿‰Ë˜ Î·È O˘Ú·Ó›· NÈÎÔ-Ï¿ÙÔ˘-°·Ï›ÙË. TÈ˜ ÂÚÁ·Û›Â˜ ÙÔ˘ ·Ú·ÎÔÏÔ‡ıËÛ·Ó Ô‰Ô-ÓÙ›·ÙÚÔÈ, ÓÔÛÔÎÔÌÂÈ·ÎÔ› Î·È ÌË, ÏÂÈÙÔ˘ÚÁÔ› ̆ ÁÂ›·˜ ¿ÏÏˆÓÎÏ¿‰ˆÓ Ô˘ Û¯ÂÙ›˙ÔÓÙ·È ÌÂ ÙËÓ ·ÚÔ¯‹ ÔÈÔÙÈÎ‹˜ Ô‰Ô-ÓÙÈ·ÙÚÈÎ‹˜ ÂÚ›ı·Ï„Ë˜, fiˆ˜ È·ÙÚÔ›, ÓÔÛËÏÂ˘Ù¤˜, Î·È Â-ÈÛÎ¤ÙÂ˜ ˘ÁÂ›·˜ ·ÏÏ¿ Î·È ÂÚÂ˘ÓËÙ¤˜ ÌË È·ÙÚÈÎÒÓ ÎÏ¿-‰ˆÓ, Î·ıÒ˜ Î·È Ï‹ıÔ˜ ÊÔÈÙËÙÒÓ Î·È ÎÔÈÓfi. H ÔÈÎ›ÏË ·˘-Ù‹ ÚÔ¤ÏÂ˘ÛË ÙˆÓ Û˘Ó¤‰ÚˆÓ ÚfiÛıÂÛÂ ¤Ó·Ó ·ÎfiÌ· ÙfiÓÔ‰È·ÊÔÚÂÙÈÎfiÙËÙ·˜ ÛÙÔ ™˘Ó¤‰ÚÈÔ ·˘Ùfi. H ÂÓÂÚÁfi˜ Û˘ÌÌÂ-ÙÔ¯‹ ÙÔ˘˜ ÛÙÔ ÚÔÛÂÁÌ¤ÓÔ ÂÈÛÙËÌÔÓÈÎfi ÚfiÁÚ·ÌÌ· Î·ÈÛÙÈ˜ ÎÔÈÓˆÓÈÎ¤˜ ÂÎ‰ËÏÒÛÂÈ˜, Ë ·Î¿Ì·ÙË ÔÏÔ‹ÌÂÚË ·Ú·-ÎÔÏÔ‡ıËÛË, Ë ·Ó¿Ù˘ÍË ÙˆÓ ·ÓıÚÒÈÓˆÓ Û¯¤ÛÂˆÓ, Ë Â-ÔÈÎÔ‰ÔÌËÙÈÎ‹ ·ÓÙ·ÏÏ·Á‹ ·fi„ÂˆÓ Î·È ÂÌÂÈÚÈÒÓ ¿ÁÁÈ-Í·Ó ÙÔ ÓÔ˘ Î·È ÙÈ˜ Î·Ú‰È¤˜ Ì·˜. ™Â fiÏ· ·˘Ù¿ ·ÎÔ‡Ú·ÛÙ·Û˘ÌÌÂÙÂ›¯Â Î·È Ô ÙÈÌËıÂ›˜ Dr Grivel Û˘ÓÔ‰Â˘fiÌÂÓÔ˜ ·fiÙËÓ Û‡˙˘Áfi ÙÔ˘.

74 ÂÏÏËÓÈÎ‹ ÓÔÛÔÎÔÌÂÈ·Î‹ Ô‰ÔÓÙÈ·ÙÚÈÎ‹ 4: 73-75, 2011

H ¶ÚfiÂ‰ÚÔ˜ ÙË˜ O‰ÔÓÙÈ·ÙÚÈÎ‹˜ ™¯ÔÏ‹˜ ÙÔ˘ ¶·ÓÂÈÛÙËÌ›Ô˘ AıËÓÒÓÎ. K·›ÙË K·Ú·ÁÈ¿ÓÓË ÚÔÛÊˆÓÂ›. ™ÙËÓ ÊˆÙÔÁÚ·Ê›· Â›ÛË˜ ‰È·ÎÚ›-ÓÔÓÙ·È Ì¤ÏË ÙÔ˘ ¶ÚÔÂ‰ÚÂ›Ô˘ ÙË˜ EENO Î·È Û˘ÁÎÂÎÚÈÌ¤Ó· Î·Ù¿ ÛÂÈ-Ú¿ ·fi ·ÚÈÛÙÂÚ¿ Ë ¶ÚfiÂ‰ÚÔ˜ Î. ºÏÒÚ· ZÂÚ‚Ô‡, Ô °ÂÓ. °Ú·ÌÌ·Ù¤-·˜ Î. M¿ÚÈÔ˜ ºÚ·ÁÎ¿ÎË˜, Ë A’ AÓÙÈÚfiÂ‰ÚÔ˜ Î. £ÂÔÓ‡ÌÊË ZÔ˘ÚÈ‰¿-ÎË Î·È Ô B’ AÓÙÈÚfiÂ‰ÚÔ˜ Î. ¶¤ÙÚÔ˜ £·ÓÔ‡ÏË˜.

O ¶ÚfiÂ‰ÚÔ˜ ÙË˜ EÏÏËÓÈÎ‹˜ O‰ÔÓÙÈ·ÙÚÈÎ‹˜ OÌÔÛÔÓ‰›·˜ Î.Aı·Ó¿ÛÈÔ˜ K·ÙÛ›ÎË˜ ÎËÚ‡ÛÛÂÈ ÙËÓ ¤Ó·ÚÍË ÙˆÓ ÂÚÁ·ÛÈÒÓ.

O ¶Ú¤Û‚Ë˜ ÙË˜ EÏ‚ÂÙ›·˜ ÛÙËÓ EÏÏ¿‰· Î. Lorenzo Amberg ·Â˘ı‡ÓÂÈ ¯·ÈÚÂÙÈÛÌfi.

O ¶ÚfiÂ‰ÚÔ˜ ÙÔ˘ O‰ÔÓÙÈ·ÙÚÈÎÔ‡ ™˘ÏÏfiÁÔ˘ ¶ÂÈÚ·ÈÒ˜ Î. ¢ËÌ‹ÙÚË˜ M·˘Ú›‰Ë˜ ÚÔÛÊˆÓÂ›.

ŒÙÛÈ, ÙÔ ™˘Ó¤‰ÚÈÔ, ÙfiÛÔ ÌÂ ÙÔ ÂÈÛÙËÌÔÓÈÎfi ÙÔ˘ Úfi-ÁÚ·ÌÌ· fiÛÔ Î·È ÌÂ ÙÔ ÊÈÏÈÎfi Î·È ˙ÂÛÙfi ÎÏ›Ì· Ô˘ ·Ó·-Ù‡¯ıËÎÂ Î·ıÒ˜ Î·È ÌÂ ÙËÓ Û‡ÛÊÈÁÍË ÙˆÓ Û¯¤ÛÂˆÓ Ô˘ÂÈÙÂ‡¯ıËÎÂ, ¤Î·ÓÂ ‰˘Ó·Ù‹ ÙËÓ ·‚›·ÛÙË ¤ÎÊÚ·ÛË ÙˆÓ ·-fi„ÂˆÓ Î·È Û˘Ó¤‚·ÏÂ ÛÙËÓ ÂÎ·›‰Â˘ÛË ÁÈ· ÙËÓ ·ÚÔ¯‹EÈ‰ÈÎ‹˜ O‰ÔÓÙÈ·ÙÚÈÎ‹˜ ºÚÔÓÙ›‰·˜ ·ÏÏ¿ Î·È ÛÙËÓ Î·Ù¿-ıÂÛË ÚÔÙ¿ÛÂˆÓ ÁÈ· ÙÈ˜ ··ÈÙÔ‡ÌÂÓÂ˜ ·ÏÏ·Á¤˜. ¢È·ÈÛÙÒıËÎÂ fiÙÈ ·Ú¿ ÙÈ˜ ÛÔ‚·Ú¤˜ ‰˘ÛÎÔÏ›Â˜ Î·È ÙÈ˜ÛËÌ·ÓÙÈÎ¤˜ ÂÏÏÂ›„ÂÈ˜ ÙÔ˘ Ô‰ÔÓÙÈ·ÙÚÈÎÔ‡ ‰˘Ó·ÌÈÎÔ‡ ÛÙ·NÔÛÔÎÔÌÂ›·, ÔÏÏ¿ O‰ÔÓÙÈ·ÙÚÈÎ¿ TÌ‹Ì·Ù· ·ÛÎÔ‡Ó ÛÂ·ÍÈfiÏÔÁÔ ‚·ıÌfi ÙËÓ EÈ‰ÈÎ‹ O‰ÔÓÙÈ·ÙÚÈÎ‹ ºÚÔÓÙ›‰· Î·È·Ú¤¯Ô˘Ó ÛËÌ·ÓÙÈÎfi ¤ÚÁÔ ÛÙ· ¿ÙÔÌ· ÌÂ ‚Â‚·ÚËÌ¤ÓÔ È·-ÙÚÈÎfi ÈÛÙÔÚÈÎfi, ÓÔËÙÈÎ‹ ˘ÛÙ¤ÚËÛË Î·È Ê˘ÛÈÎ‹ ·Ó·ËÚ›·.Afi ÔÏÏÔ‡˜ ÔÌÈÏËÙ¤˜ ÂÈÛËÌ¿ÓıËÎÂ ÌÂ ¤ÌÊ·ÛË Ë ·Ó¿-ÁÎË ÂÈ‰ÈÎ‹˜ ÂÎ·›‰Â˘ÛË˜ ÙˆÓ ÏÂÈÙÔ˘ÚÁÒÓ ÙË˜ ‰Â˘ÙÂÚÔ-‚¿ıÌÈ·˜ Ô‰ÔÓÙÈ·ÙÚÈÎ‹˜ ÊÚÔÓÙ›‰·˜ ÛÙÔ Â˘Ú‡ ÎÏÈÓÈÎfi ·-ÓÙÈÎÂ›ÌÂÓÔ Ô˘ ÍÂÎÈÓ¿ ·fi ÙËÓ ÚfiÏË„Ë, ‰È¿ÁÓˆÛË ‹ ıÂ-Ú·Â›· ÙÔ˘ ÂÈ‰ÈÎÔ‡ Ô‰ÔÓÙÈ·ÙÚÈÎÔ‡ ·ÛıÂÓÔ‡˜ Î·È ÊÙ¿ÓÂÈÌ¤¯ÚÈ ÙËÓ I·ÙÚÔ‰ÈÎ·ÛÙÈÎ‹ ÙÔ˘ ™ÙfiÌ·ÙÔ˜ Î·È Ù· SpecialOlympics ÙË˜ Aı‹Ó·˜.OÈ Î‡ÚÈÂ˜ ÚÔÙ¿ÛÂÈ˜ Ô˘ ÚÔ¤Î˘„·Ó ·fi ÙÔ ÊÈÏfiÍÂÓÔ‚‹Ì· ˙‡ÌˆÛË˜ ÙˆÓ ÂÈÛÙËÌÔÓÈÎÒÓ ·fi„ÂˆÓ ‹Ù·Ó ÔÈ ·-ÎfiÏÔ˘ıÂ˜:1. ™˘ÌÏ‹ÚˆÛË ÙˆÓ ÎÂÓÒÓ ı¤ÛÂˆÓ ÛÙ· O‰ÔÓÙÈ·ÙÚÈÎ¿TÌ‹Ì·Ù· ÙˆÓ NÔÛÔÎÔÌÂ›ˆÓ ÌÂ ÚÔÎ‹Ú˘ÍË ÔÚÁ·ÓÈÎÒÓı¤ÛÂˆÓ, ÚÔÎ‹Ú˘ÍË ı¤ÛÂˆÓ ÂÈÎÔ˘ÚÈÎÒÓ ‹ ÌÂ ÌÂÙ·Î›ÓË-ÛË ÚÔÛˆÈÎÔ‡.2. EÎ·›‰Â˘ÛË ÛÙËÓ EÈ‰ÈÎ‹ O‰ÔÓÙÈ·ÙÚÈÎ‹ ºÚÔÓÙ›‰·:·. K·ıÈ¤ÚˆÛË EÍÂÈ‰›ÎÂ˘ÛË˜ ÛÙË NÔÛÔÎÔÌÂÈ·Î‹ O‰Ô-ÓÙÈ·ÙÚÈÎ‹ - O‰ÔÓÙÈ·ÙÚÈÎ‹ EÈ‰ÈÎ‹˜ ºÚÔÓÙ›‰·˜.‚. ™˘ÓÂ¯È˙fiÌÂÓË EÎ·›‰Â˘ÛË ÛÙËÓ EÈ‰ÈÎ‹ O‰ÔÓÙÈ·ÙÚÈÎ‹ºÚÔÓÙ›‰· ÁÈ· ÙÔ˘˜ ‹‰Ë ̆ ËÚÂÙÔ‡ÓÙÂ˜ Ô‰ÔÓÙÈ¿ÙÚÔ˘˜ ÙˆÓNÔÛÔÎÔÌÂ›ˆÓ Û‡ÌÊˆÓ· ÌÂ Û˘ÁÎÂÎÚÈÌ¤ÓÔ ıÂˆÚËÙÈÎfi Î·ÈÎÏÈÓÈÎfi ÂÎ·È‰Â˘ÙÈÎfi ÚfiÁÚ·ÌÌ·.H EÏÏËÓÈÎ‹ EÙ·ÈÚÂ›· NÔÛÔÎÔÌÂÈ·Î‹˜ O‰ÔÓÙÈ·ÙÚÈÎ‹˜,Ô˘ ¤¯ÂÈ Î·ıÈÂÚˆıÂ› ˆ˜ Â›ÛËÌÔ˜ ÂÈÛÙËÌÔÓÈÎfi˜ ÊÔÚ¤-·˜ ÙË˜ EÈ‰ÈÎ‹˜ O‰ÔÓÙÈ·ÙÚÈÎ‹˜ ºÚÔÓÙ›‰·˜ ÛÙËÓ EÏÏ¿‰·Î·È ¤¯ÂÈ Û˘Ì‚¿ÏÂÈ ÛÂ ÌÂÁ¿ÏÔ ‚·ıÌfi ÛÙËÓ ·Ó¿‰ÂÈÍË ÙÔ˘

·ÓÙÈÎÂÈÌ¤ÓÔ˘ ·˘ÙÔ‡ Î·ıÒ˜ Î·È ÛÙËÓ ·Ó¿‰ÂÈÍË ÙË˜ ÛÔ˘-‰·ÈfiÙËÙ·˜ ÙÔ˘ ÚfiÏÔ˘ ÙÔ˘ ÓÔÛÔÎÔÌÂÈ·ÎÔ‡ Ô‰ÔÓÙÈ¿ÙÚÔ˘,Î·ÏÂ›Ù·È Ó· Û˘ÓÂ¯›ÛÂÈ ÙÈ˜ ÔÏ˘Ô›ÎÈÏÂ˜ ÚÔÛ¿ıÂÈ¤˜ÙË˜, Ô˘ ÙÂÏÈÎfi ÛÙfi¯Ô ¤¯Ô˘Ó ÙË ‚ÂÏÙ›ˆÛË ÙÔ˘ ÂÈ¤‰Ô˘ÙË˜ ·ÚÂ¯fiÌÂÓË˜ ÂÚ›ı·Ï„Ë˜ ÛÙÔÓ ÂÈ‰ÈÎfi ·ÛıÂÓ‹.


O °ÂÓ. °Ú·ÌÌ·Ù¤·˜ ÙË˜ EENO Î. M¿ÚÈÔ˜ ºÚ·ÁÎ¿ÎË˜ ·ÚÔ˘ÛÈ¿˙ÂÈ ÙÔ ‚ÈÔÁÚ·ÊÈÎfi ÙÔ˘ Dr Julien Grivel.

H ¶ÚfiÂ‰ÚÔ˜ ÙË˜ EENO Î. ºÏÒÚ· ZÂÚ‚Ô‡ ·Ó·ÎËÚ‡ÛÛÂÈ ÙÔÓDr Julien Grivel E›ÙÈÌÔ ¶ÚfiÂ‰ÚÔ ÙË˜ EÙ·ÈÚÂ›·˜ Î·È ÙÔ˘ ÂÈ-‰›‰ÂÈ ÙËÓ ÙÈÌËÙÈÎ‹ Ï·Î¤Ù·.

™ÙÈÁÌÈfiÙ˘· ·fi ÙËÓ ‰ÂÍ›ˆÛË

°ÂÓÈÎ‹ ¿Ô„Ë

O Dr Julien Grivel ÌÂÙ¿ ÙË˜ Û˘˙‡ÁÔ˘ ÙÔ˘, Ë ¶ÚfiÂ‰ÚÔ˜ ÙË˜ EENO Î. ºÏÒÚ· ZÂÚ‚Ô‡-B¿Ï‚Ë Î·È Ô °ÂÓ. °Ú·ÌÌ·Ù¤·˜ Î. M¿ÚÈÔ˜ ºÚ·ÁÎ¿ÎË˜



EÙ‹ÛÈ· ŒÎ‰ÔÛË ÙË˜

EÏÏËÓÈÎ‹˜ EÙ·ÈÚÂ›·˜ NÔÛÔÎÔÌÂÈ·Î‹˜ O‰ÔÓÙÈ·ÙÚÈÎ‹˜

ISSN 1791-9130

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